Universität zu Köln

Lennartz, Simon, Hokamp, Nils Grosse, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Le Blanc, Markus, Iuga, Andra-Iza, Bratke, Grischa, Zopfs, David ORCID: 0000-0001-9978-7453, Maintz, David, Borggrefe, Jan ORCID: 0000-0003-2908-7560 and Persigehl, Thorsten (2019). Diagnostic value of spectral reconstructions in detecting incidental skeletal muscle metastases in CT staging examinations. Cancer Imaging, 19. LONDON: BMC. ISSN 1740-5025

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Abstract

Background: To investigate if iodine density overlay maps (IDO) and virtual monoenergetic images at 40 keV (VMI40keV) acquired from spectral detector computed tomography (SDCT) can improve detection of incidental skeletal muscle metastases in whole-body CT staging examinations compared to conventional images. Methods: In total, 40 consecutive cancer patients who underwent clinically-indicated, contrast-enhanced, oncologic staging SDCT were included at this retrospective study: 16 patients with n = 108 skeletal muscle metastases confirmed by prior or follow-up CT, F-18-FDG-PET, MRI or histopathology, and a control group of 24 patients without metastases. Four independent readers performed blinded, randomized visual detection of skeletal muscle metastases in conventional images, IDO and VMI40keV, indicating diagnostic certainty for each lesion on a 5-point Likert scale. Quantitatively, ROI-based measurements of attenuation (HU) in conventional images and VMI40keV and iodine concentration in IDO were conducted. CNR was calculated and receiver operating characteristics (ROC) analysis of quantitative parameters was performed. Results: Regarding subjective assessment, IDO (63.2 (58.5-67.8) %) and VMI40keV (54.4 (49.6-59.2) %) showed an increased sensitivity for skeletal muscle metastases compared to conventional images (39.8 (35.2-44.6) %). Specificity was comparable in VMI40keV (69.8 (63.2-75.8) %) and conventional images (69.2 (60.6-76.9) %), while in IDO, it was moderately increased to 74.2 (65.3-78.4) %. Quantitative image analysis revealed that CNR of skeletal muscle metastases to circumjacent muscle was more than doubled in VMI40keV (25.8 +/- 11.1) compared to conventional images (10.0 +/- 5.3, p <= 0.001). Iodine concentration obtained from IDO and HU acquired from VMI40kev (AUC = 0.98 each) were superior to HU attenuation in conventional images (AUC = 0.94) regarding differentiation between healthy and metastatic muscular tissue (p <= 0.05). Conclusions: IDO and VMI40keV provided by SDCT improve diagnostic accuracy in the assessment of incidental skeletal muscle metastases compared to conventional CT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Le Blanc, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Iuga, Andra-Iza UNSPECIFIED UNSPECIFIED UNSPECIFIED Bratke, Grischa UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED orcid.org/0000-0001-9978-7453 UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-135002
DOI:	10.1186/s40644-019-0235-3
Journal or Publication Title:	Cancer Imaging
Volume:	19
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1740-5025
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; ADENOCARCINOMA; COEFFICIENT; CARCINOMA; COLON Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13500