Side-by-side reading of PET and CT scans in oncology: which patients might profit from integrated PET/CT?

Reinartz, Patrick; Wieres, F. J.; Schneider, Wolfram; Schur, Alexander; Buell, U.

doi:10.1007/s00259-004-1593-y

Cited by 66 publications

(35 citation statements)

References 19 publications

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“…Several approaches to combining information from CT and FDG-PET exist: side-by-side viewing of image data sets, which has been described to provide superior diagnostic accuracy compared to the stand-alone evaluation of PET tomograms [1,2] or registering image data from both modalities and visualizing the result of that process on a common computer platform [3]. This may be achieved either by software dedicated to registering images from separately acquired datasets [2] or by the so-called hybrid cameras integrating a PET camera and a CT scanner within one gantry [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

et al. 2007

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Object: This retrospective study compares the anatomical accuracy of automated rigid and non-rigid registration software for aligning data from separately performed X-ray computed tomography (CT) and positron emission tomography with F-18-deoxyglucose (PET). Materials and methods: Analyses were performed on independently acquired PET and CT data from 40 tumor patients. Rigid as well as non-rigid automated fusion was carried out using the commercially available Mirada 7D platform (MIR and MINR, respectively) as well as a second automated nonrigid registration based on a variational image registration approach (VIR). Distances between lesion representation on PET and CT of 105 malignant lesions were measured in X-, Y-, and Z-directions. Statistical evaluation was performed using mixed effect analysis, comparing separately MIR with MINR and VIR with MINR. Results:The percentage of lesions misregistered by less than 15 mm varied from 70% for MIR and MINR in Z-direction to 93% for VIR in X-direction. The average X-, Y-and Z-distances ranged between 5.9 ± 5.7 mm for VIR in X-direction and 12.8 ± 9.7 mm for MIR in Z-direction. MINR was significantly more accurate than MIR in Y-direction. Furthermore, VIR aligned thoracic lesions in the X-direction significantly better than MINR. Conclusion: The accuracy of rigid and non-rigid automated image registration can be expected to be better than 15 mm for the majority of lesions. Alignment tended to be more accurate with non-rigid registration.

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Section: Introductionmentioning

confidence: 99%

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

et al. 2007

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“…Up to 50% of adrenal lesions in patients with known primary non-adrenal cancers are malignant disease [1][2][3][4]. The most common malignant lesions that metastasise to the adrenal gland include lung, liver, colon, lymphoma, melanoma, breast, kidney, oesophagus, pancreas and stomach cancer [4][5][6].…”

mentioning

confidence: 99%

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Kim

Kim²,

Lee³

et al. 2013

BJR

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Objective: To assess the properties of adrenal lesions with and without known primary cancer and investigate predictors for differential diagnosis between benign and malignant adrenal enlargement. Methods: This retrospective study used fluorine-18 fludeoxyglucose positron emission tomography (PET)/CT in 325 patients with adrenal lesions (229 with known primary cancer and 96 without primary cancer). Age, sex, the presence of right and left masses, nodules or hyperplasia, unenhanced attenuation, maximum standardised uptake value (SUV max ) ratio, and the presence of metastasis in other body parts and locations of the primary cancer were assessed. Univariate and multivariate analyses were used to assess variables associated with risk of adrenal metastasis. Results: Patients with adrenal metastasis vs those without had a higher frequency of primary lung cancer (52.3% vs 30.7%) but a lower frequency of gastrointestinal cancer (7.9% vs 16.6%). The frequency of other abnormalities, including adenoma and hyperplasia, was similar between patients with and without known primary cancer. A higher proportion of patients with adrenal metastasis regardless of primary cancer site were younger, had a nodule or a mass, had an unenhanced attenuation of .10 HU, had an SUV max ratio of .2.5, and had metastasis in other body parts. Analysis found independent associations of age, unenhanced attenuation of .10 HU, SUV max ratio of .2.5 and the presence of metastasis in other body parts with adrenal metastasis. The combination of the four variables was strongly associated with adrenal metastasis. Conclusion: PET/CT was useful in characterising adrenal lesions as benign or malignant and helpful in identifying adrenal metastasis and cancer severity. Advances in knowledge: PET/CT can help in the differential diagnosis between benign and malignant adrenal enlargement.The adrenal gland is a common site of metastasis in patients with cancer. Up to 50% of adrenal lesions in patients with known primary non-adrenal cancers are malignant disease [1-4]. The most common malignant lesions that metastasise to the adrenal gland include lung, liver, colon, lymphoma, melanoma, breast, kidney, oesophagus, pancreas and stomach cancer [4][5][6]. However, diagnosis of an adrenal lesion as malignant or benign can be problematic. Characterisation of these adrenal lesions is therefore critical to stage the primary disease, direct therapy and predict prognosis. Although CT and MRI are typically used to characterise a lesion, a small but important number of adrenal lesions are found to be indeterminate on crosssectional images [7][8][9].Several reports have documented the effectiveness of standalone fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET) to differentiate benign from malignant adrenal lesions [8][9][10]. Interest has focused on the ability of integrated in-line PET/CT to definitively characterise these lesions given that this technique combines the anatomical and densitometrical applications of CT and the functional and metabol...

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“…There is wide consensus that adding CT data to evaluate PET lesions reduces the number of unclassifiable lesions by close to 50% [3] and that in more than 50% of the lesions seen on PET, CT information is needed to confidently classify the lesions [4]. The reasons for this are simple.…”

Section: Unenhanced Ct For Anatomic Reference Purposesmentioning

confidence: 97%

Integrated modality imaging with PET-CT and SPECT-CT: CT issues

Schulthess

2005

Eur Radiol Suppl

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The advantages of combining PET with CT are multiple and due to the anatomic referencing and the attenuation correction capabilities, which CT introduces, as well as a resulting increase in imaging speed and more efficient use of radiopharmaceuticals. These synergistic advantages are gained with combining PET-CT, but less so when combining SPECT-CT and almost not at all, when combining PET or SPECT with MR. PET-CT in oncology has firmly established itself as the best imaging modality in many settings of tumor staging and therapy monitoring. Whether the CT used in the combined imaging approach should be a full scale contrast enhanced CT or a low mAs unenhanced scan is currently a matter of debate. The use of contrast enhanced CT in PET-CT should be guided primarily by the availability of a prior recent enhanced CT-only scan and the diagnostic questions to be answered by the PET-CT examination and not by turf issues between nuclear physicians and radiologists. The future of combined imaging seems bright, as applications in SPECT-CT and in other disease entities are emerging.

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Side-by-side reading of PET and CT scans in oncology: which patients might profit from integrated PET/CT?

Cited by 66 publications

References 19 publications

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Integrated modality imaging with PET-CT and SPECT-CT: CT issues

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Side-by-side reading of PET and CT scans in oncology: which patients might profit from integrated PET/CT?

Cited by 66 publications

References 19 publications

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

Comparison of performance between rigid and non-rigid software registering CT to FDG-PET

Utilisation of combined18F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Integrated modality imaging with PET-CT and SPECT-CT: CT issues

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Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement