Value of contrast CT in combination with PET/CT in mesothelioma staging: Optimal protocol for initial assessment

Value of contrast CT in combination with PET/CT in mesothelioma staging: Optimal protocol for initial assessment

To assess the value of contrast enhanced CT (ceCT) when added to positron emission tomography combined with the standard low-dose non-contrast CT (PET/CT) protocols for staging patients with malignant pleural mesothelioma (MPM). Retrospective analysis of 47 patients with pathologically proved MPM. A...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine Vol. 48; no. 1; pp. 67 - 74
Main Authors: Houseni, Mohamed, Osama, Amr, Mohamed, Dalia Ibrahim, Salem, Shahinda
Format: Journal Article
Language:English
Published: Elsevier B.V 01-03-2017
SpringerOpen
Subjects:
18F-FDG-PET
Contrast CT
Mesothelioma staging
PET/CT
Mesothelioma staging
18F-FDG-PET
Contrast CT
PET/CT
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Summary:To assess the value of contrast enhanced CT (ceCT) when added to positron emission tomography combined with the standard low-dose non-contrast CT (PET/CT) protocols for staging patients with malignant pleural mesothelioma (MPM). Retrospective analysis of 47 patients with pathologically proved MPM. All patients underwent PET/CT with low dose CT followed by ceCT. PET/CT and ce-CT were evaluated separately then in combination. All the results were validated either by histopathology and/or clinical-radiological follow-up. Staging was performed based on TNM system. For T-stage, the sensitivities for PET/CT, ceCT and combined PET/CT-ceCT were 89.1%, 86.9%, and 97.5%, respectively, p=0.04. Regarding nodal stage, the sensitivity, specificity and accuracy for PET/CT were 88.5%, 90.5%, and 89.4%; for ceCT 73.1%, 95.2% and 82.9%; and for PET/CT-ceCT 96.2%, 95.2% and 95.7%, respectively. PET/CT-ceCT significantly associated with the sensitivity, p=0.05. Considering the metastatic disease, the sensitivity, specificity and accuracy for PET/CT were 81.3%, 96.8%, and 91.5%; for ceCT 56.3%, 90.3% and 78.7%; and for PET/CT-ceCT 93.8%, 96.8% and 95.7%, respectively. PET/CT-ceCT significantly improved the sensitivity (p=0.03) and accuracy (p=0.02). Furthermore, combined PET/CT-ceCT significantly identified patients not suitable for surgery. The addition of ceCT to PET/CT protocol has significantly contributed to the staging of MPM.
ISSN:0378-603X
DOI:10.1016/j.ejrnm.2016.12.011