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Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients

OBJECTIVES: To investigate the diagnostic impact and performance of spectral dual-layer detector CT in the detection and characterization of cancer compared to conventional CE-CT. METHODS: In a national workup program for occult cancer, 503 patients (286 females and 217 males) were prospectively enr...

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Autores principales: Andersen, Michael Brun, Ebbesen, Dyveke, Thygesen, Jesper, Kruis, Matthijs, Rasmussen, Finn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476920/
https://www.ncbi.nlm.nih.gov/pubmed/32367416
http://dx.doi.org/10.1007/s00330-020-06878-7
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author Andersen, Michael Brun
Ebbesen, Dyveke
Thygesen, Jesper
Kruis, Matthijs
Rasmussen, Finn
author_facet Andersen, Michael Brun
Ebbesen, Dyveke
Thygesen, Jesper
Kruis, Matthijs
Rasmussen, Finn
author_sort Andersen, Michael Brun
collection PubMed
description OBJECTIVES: To investigate the diagnostic impact and performance of spectral dual-layer detector CT in the detection and characterization of cancer compared to conventional CE-CT. METHODS: In a national workup program for occult cancer, 503 patients (286 females and 217 males) were prospectively enrolled for a contrast-enhanced spectral CT scan. The readings were performed with and without spectral data available. A minimum of 3 months between interpretations was implemented to minimize recall bias. The sequence of reads for the individual patient was randomized. Readers were blinded for patient identifiers and clinical outcome. Two radiologists with 9 and 33 years of experience performed the readings in consensus. If disagreement, a third radiologist with 11 years of experience determined the outcome of the reading RESULTS: Significantly more cancer findings were identified on the spectral reading. In 73 cases of proven cancer, we found a sensitivity of 89% vs 77% and a specificity of 77% vs 83% on spectral CT compared to conventional CT. A slight increase in reading time in spectral images of 82 s was found (382 vs 300, p < 0.001). For all cystic lesions, the perceived diagnostic certainty increased from 30% being completely certain to 96% most pronounced in the kidney, liver, thyroid, and ovaries. And adding the spectral information to the reading gave a decrease in follow-up examination for diagnostic certainty (0.25 vs 0.81 per reading, p < 0.001). CONCLUSION: The use of contrast-enhanced spectral CT increases the confidence of the radiologists in correct characterization of various lesions and minimizes the need for supplementary examinations. KEY POINTS: • Spectral CT is associated with a higher sensitivity, but a slightly lower specificity compared to conventional CT. • Spectral CT increases the confidence of the radiologists. • The need for supplementary examinations is decreased, with only a slight increase in reading times. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00330-020-06878-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-74769202020-09-21 Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients Andersen, Michael Brun Ebbesen, Dyveke Thygesen, Jesper Kruis, Matthijs Rasmussen, Finn Eur Radiol Oncology OBJECTIVES: To investigate the diagnostic impact and performance of spectral dual-layer detector CT in the detection and characterization of cancer compared to conventional CE-CT. METHODS: In a national workup program for occult cancer, 503 patients (286 females and 217 males) were prospectively enrolled for a contrast-enhanced spectral CT scan. The readings were performed with and without spectral data available. A minimum of 3 months between interpretations was implemented to minimize recall bias. The sequence of reads for the individual patient was randomized. Readers were blinded for patient identifiers and clinical outcome. Two radiologists with 9 and 33 years of experience performed the readings in consensus. If disagreement, a third radiologist with 11 years of experience determined the outcome of the reading RESULTS: Significantly more cancer findings were identified on the spectral reading. In 73 cases of proven cancer, we found a sensitivity of 89% vs 77% and a specificity of 77% vs 83% on spectral CT compared to conventional CT. A slight increase in reading time in spectral images of 82 s was found (382 vs 300, p < 0.001). For all cystic lesions, the perceived diagnostic certainty increased from 30% being completely certain to 96% most pronounced in the kidney, liver, thyroid, and ovaries. And adding the spectral information to the reading gave a decrease in follow-up examination for diagnostic certainty (0.25 vs 0.81 per reading, p < 0.001). CONCLUSION: The use of contrast-enhanced spectral CT increases the confidence of the radiologists in correct characterization of various lesions and minimizes the need for supplementary examinations. KEY POINTS: • Spectral CT is associated with a higher sensitivity, but a slightly lower specificity compared to conventional CT. • Spectral CT increases the confidence of the radiologists. • The need for supplementary examinations is decreased, with only a slight increase in reading times. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00330-020-06878-7) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-05-04 2020 /pmc/articles/PMC7476920/ /pubmed/32367416 http://dx.doi.org/10.1007/s00330-020-06878-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Oncology
Andersen, Michael Brun
Ebbesen, Dyveke
Thygesen, Jesper
Kruis, Matthijs
Rasmussen, Finn
Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title_full Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title_fullStr Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title_full_unstemmed Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title_short Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
title_sort impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476920/
https://www.ncbi.nlm.nih.gov/pubmed/32367416
http://dx.doi.org/10.1007/s00330-020-06878-7
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