Impact of contrast-enhanced 18F-FDG PET/CT in clinical oncology: tumor-, site- and question-based comparison with standard PET/CT (Abstract in rivista)

Type
Label
  • Impact of contrast-enhanced 18F-FDG PET/CT in clinical oncology: tumor-, site- and question-based comparison with standard PET/CT (Abstract in rivista) (literal)
Anno
  • 2012-01-01T00:00:00+01:00 (literal)
Alternative label
  • S. Morbelli; R. Conzi; C. Campus; G. Cittadini; I. Bossert; M. Massollo; Cecilia Marini; C. Ghersi; S. Fiordoro; E. Giglio; P. Perfumo; L. Derchi; Gianmario Sambuceti. (2012)
    Impact of contrast-enhanced 18F-FDG PET/CT in clinical oncology: tumor-, site- and question-based comparison with standard PET/CT
    (literal)
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  • S. Morbelli; R. Conzi; C. Campus; G. Cittadini; I. Bossert; M. Massollo; Cecilia Marini; C. Ghersi; S. Fiordoro; E. Giglio; P. Perfumo; L. Derchi; Gianmario Sambuceti. (literal)
Pagina inizio
  • S227 (literal)
Pagina fine
  • S228 (literal)
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  • 39 (literal)
Rivista
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  • Suppl-2 (literal)
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  • Nuclear Medicine Unit, San Martino Hospital, Genoa, Italy. Department of Radiology, San Martino Hospital, Genoa, Italy. Italian Institute of Technology (IIT), Genoa, Italy. Institute of Molecular Bioimaging and Physiology, CNR, UOS Genoa, Italy. (literal)
Titolo
  • Impact of contrast-enhanced 18F-FDG PET/CT in clinical oncology: tumor-, site- and question-based comparison with standard PET/CT (literal)
Abstract
  • The present study aimed to evaluate the incremental value of contrast-enhanced multiphase CT (ceCT) associated with conventional PET/CT protocols implying a low-dose non-contrast CT in oncological imaging. Methods: Analysis was performed in 202 patients (597 lesions) who underwent a PET/CT consisting of a multiphase CT protocol including a low-dose non-enhanced attenuation scan and an arterial and portal-venous contrast-enhanced scan followed by a whole-body PET. Cochran-Q test, followed by multiple comparisons using the McNemar test with continuity correction and Bonferroni adjustment were performed to calculate for each technique (PET/CT, ceCT and cePET/CT) the following parameters : sensitivity (Se), specificity (Sp), overall accuracy, positive and negative predictive values (PPV, NPV), Likelihood Ratios (LR), Diagnostic Odds Ratio (DOR) and Error Rate. Histopathology served as a gold standard in 74 patients (133 lesions), while clinical-radiological follow up >1year was used as a reference in the remaining patients. All the analyses were computed considering the tumor types (lung, head and neck, gastrointestinal and breast cancer, lymphoma, melanoma, multiple myeloma), the divergent site of disease (neck, thorax, abdomen, lymph nodes and bone) and, finally, clinical question (diagnosis, staging, response to chemotherapy, response to radiotheraphy, restaging, surveillance). Results: Cochran Q-test documented a significant difference between the three techniques (Cochran's Q = 58.3969, df = 2, P<10-12). However in pair-wise comparison using McNemar's tests, cePET/CT was superior to CT (McNemar's chi-squared = 12.55, df = 1, adjusted P<0.05) while it was similar to PET/CT. Both cePET/CT and PET/CT had better Sp, PPV, PLR, DOR, Error Rate and Accuracy compared to ceCT. CePET/CT presented the highest values of NPV and negative LR. The results were superimposable in the subgroups of patients with or without histo-pathological control. The benefit of diagnostic ceCT with respect of percentage of change in clinical management was evident in selected tumor types (head-neck, 22%and gastrointestinal cancer, 16%), in selected tumor sites (neck and abdomen, 24%) and in selected clinical questions (restaging, 15%). Conclusion: When clinically indicated, PET/CT performed with low-dose CT is adequate for the work-up of several tumor types. CeCT can improve the diagnostic potential of hybrid imaging in specific clinical conditions in which it frequently causes a significant change in patient management. (literal)
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