ORIGINAL ARTICLES  CLINICAL OUTCOMES OF AMYLOID IMAGIN IN CROSS SECTIONAL AND LONGITUDINAL STUDIES 

The Quarterly Journal of Nuclear Medicine and Molecular imaging 2011 June;55(3):324-33

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Influence of PET/CT on radiologists and contrast-enhanced CT on nuclear medicine physicians in patients with lymphoma

Ouvrier M. J. ^{1, 2}, Diologent B. ³, Edet-Sanson A. ^{1, 2}, Callonnec F. ³, Hitzel A. ^{1, 2}, Pesquet A. S. ³, Hapdey S. ^{1, 2}, Modzelewski R. ^{1, 2}, Thillays M. ⁴, Menard J. F. ⁵, Jardin F. ⁶, Tilly H. ⁶, Vera P. ^{1, 2} ✉

¹ Department of Nuclear Medicine, Henri Becquerel Centre, Rouen, France; ² Department of Nuclear Medicine, Rouen University Hospital, Rouen, France; ³ Department of Radiology, Henri Becquerel Centre, Rouen, France; ⁴ Department of Clinical Research, Henri Becquerel Centre, Rouen, France; ⁵ Department of Biostatistics, Rouen University Hospital, Rouen, France; ⁶ Department of Haematology, Henri Becquerel Centre, Rouen, France

AIM: We assessed in this study the influence of contrast-enhanced CT (ceCT) on PET/CT interpretation and PET/CT on ceCT interpretation in patients with lymphoma, before and after chemotherapy.
METHODS: Fifty patients with Hodgkin disease (N.=17) or non-Hodgkin lymphomas (N.=33) were assessed before and after chemotherapy. PET/CT were performed 60 minutes after injection of FDG. Iopamidol was then injected and followed, 50 seconds later, by another CT. PET images were successively reconstructed using non-enhanced CT (PET-) and ceCT (PET+). Four nuclear physicians rated PET- and PET+ in random order. Three radiologists initially rated ceCT alone and then ceCT along with PET+.
RESULTS: Before chemotherapy, global agreement (GA) was 99% (k=0.96) when PET- was compared to PET+. Nine (5%) lesions were discordant, 5 according to PET- and 4 to PET+. After chemotherapy, GA was 99% (k=0.91). Eight (15%) lesions were discordant, 3 according to PET- and 5 to PET+. Before chemotherapy, GA was 97% (k=0.91) when ceCT was compared to ceCT with PET+. Twenty-one (12%) lesions were discordant, 16 when ceCT were analyzed alone and 5 when ceCT was analyzed with PET+. After chemotherapy, GA was 95% (k=0.76). All 30 (35%) discordant lesions were positive according to ceCT alone. A significant difference between the 2 procedures was found in the pelvis and in the groin (P<0.05).
CONCLUSION: PET+ did not differ from PET-, before and after chemotherapy. Fewer abnormalities were observed, when ceCT was analyzed with PET+, particularly after chemotherapy, due to residual masses that are better analyzed with functional imaging.