Cross-modality PET/CT and contrast-enhanced CT imaging for pancreatic cancer

Abstract Abstract 1402 Poster Board I-424 Introduction: Anatomic imaging using contrast-enhanced computed tomography (CT) is essential for management of lymphomas. Functional imaging using 18FDG-PET (PET) improves detection of certain lymphomas, specifically, diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Currently, PET imaging is performed with co-registration of low-dose non-contrast enhanced CT images used for anatomic correlation and attenuation correction of PET images (PET/CT). It has been suggested that the low-dose non-enhanced CT cannot substitute for diagnostic contrast-enhanced CT imaging since the arterial and venous phases of contrast enhancement improve detection of lesions. Given the differential sensitivity for detection of specific lymphomas by PET imaging, we hypothesized that FDG could substitute for intravenous contrast in imaging of certain lymphomas, and that PET/CT or PET imaging could potentially obviate the need for contrast-enhanced CT. To test this hypothesis, we performed an independent and blinded radiology review of these imaging studies in patients (pts) with DLBCL, FL, small lymphocytic lymphoma/chronic lymphocytic leukemia (CLL/SLL) or marginal zone lymphoma (MZL) who had contrast-enhanced CT, PET, PET/CT, and low-dose non-enhanced CT available for retrospective review. Patients and Methods: Pts with a diagnosis of DLBCL, FL, CLL/SLL, or MZL with PET/CT and contrast-enhanced CT studies performed at the Hospital of the University of Pennsylvania within 6 weeks of each other without intervening therapy were studied. Pts with clinically suspected progression of lymphoma between studies were excluded. Radiologists, blinded to clinical information or other imaging results, separately interpreted image sets of low-dose non-enhanced CT, PET, fusion PET/CT, and contrast-enhanced CT studies. The presence or absence of disease at 44 nodal and 48 (female) or 49 (male) extranodal sites was recorded for each site for each imaging modality. Concordant findings across imaging modalities were defined as positive for involvement by lymphoma; discordant findings were reconciled using all available clinical and radiologic information with follow-up for progression or regression of abnormality, or by biopsy. Results: Between May 2006 and January 2008, 55 pts with either DLBCL (n=31), FL (n=13), CLL/SLL (n=5), or MZL (n=6) had complete images sets available for review. All patients had at least 18 months of clinical follow-up after imaging. A total of 282 sites met criteria for involvement by lymphoma. The rates of detection for specific lymphomas by each imaging modality are shown below: Conclusions: Our results suggest that combined PET/CT imaging is more sensitive than contrast-enhanced CT imaging for detection of DLBCL and at least as sensitive as contrast-enhanced CT imaging for detection of FL. In comparison, contrast-enhanced CT imaging appears superior to PET/CT imaging for CLL/SLL; while further studies are needed to confirm superiority of contrast-enhanced CT imaging in MZL. The routine use of both contrast enhanced CT and PET/CT modalities for staging of lymphoma may be unnecessary, potentially increasing both the cost of medical care and radiation exposure. Additional studies are needed to determine which imaging modality is optimal for each type of lymphoma. Disclosures: No relevant conflicts of interest to declare.

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Comparison of contrast-enhanced CT, PET/CT, PET, and low-dose non-contrast enhanced CT imaging of diffuse large B-cell (DLBCL), follicular (FL), small lymphocytic/CLL (CLL/SLL), and marginal zone lymphomas (MZL).

Journal of Clinical Oncology ◽

10.1200/jco.2010.28.15_suppl.8079 ◽

2010 ◽

Vol 28 (15_suppl) ◽

pp. 8079-8079 ◽

Cited By ~ 1

Author(s):

E. A. Chong ◽

D. A. Torigian ◽

A. Alavi ◽

J. Svoboda ◽

S. Nasta ◽

...

Keyword(s):

B Cell ◽

Low Dose ◽

Marginal Zone ◽

Ct Imaging ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

Large B Cell

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PET/CT and contrast-enhanced CT imaging findings in benign solitary schwannomas

European Journal of Radiology ◽

10.1016/j.ejrad.2021.109820 ◽

2021 ◽

pp. 109820

Author(s):

Si-yun Wang ◽

Jian-hua Liu ◽

Su Yao ◽

Shu-xia Wang ◽

Dan Shao

Keyword(s):

Ct Imaging ◽

Imaging Findings ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct

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DeepPrognosis: Preoperative Prediction of Pancreatic Cancer Survival and Surgical Margin via Contrast-Enhanced CT Imaging

Medical Image Computing and Computer Assisted Intervention – MICCAI 2020 - Lecture Notes in Computer Science ◽

10.1007/978-3-030-59713-9_27 ◽

2020 ◽

pp. 272-282

Author(s):

Jiawen Yao ◽

Yu Shi ◽

Le Lu ◽

Jing Xiao ◽

Ling Zhang

Keyword(s):

Pancreatic Cancer ◽

Cancer Survival ◽

Surgical Margin ◽

Ct Imaging ◽

Preoperative Prediction ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

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Multiphase contrast-enhanced CT with highly concentrated contrast agent can be used for PET attenuation correction in integrated PET/CT imaging

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-011-1919-5 ◽

2011 ◽

Vol 39 (2) ◽

pp. 316-325 ◽

Cited By ~ 16

Author(s):

Philip Aschoff ◽

Christian Plathow ◽

Thomas Beyer ◽

Matthias P. Lichy ◽

Gunter Erb ◽

...

Keyword(s):

Contrast Agent ◽

Attenuation Correction ◽

Ct Imaging ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct

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EXTH-30. EXPANDING THE UTILITY OF PRE-CLINICAL CONTRAST ENHANCED CT (CE-CT) FOR TUMOR DETECTION IN ORTHOTOPIC GBM MODELS USING RADIOMICS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.384 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii93-ii93

Author(s):

Kate Connor ◽

Emer Conroy ◽

Kieron White ◽

Liam Shiels ◽

William Gallagher ◽

...

Keyword(s):

Imaging Modality ◽

Texture Features ◽

Tumor Detection ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

Magnetic Resonance Imaging Mri ◽

Work Supports ◽

Selection Of

Abstract Despite magnetic resonance imaging (MRI) being the gold-standard imaging modality in the glioblastoma (GBM) setting, the availability of rodent MRI scanners is relatively limited. CT is a clinically relevant alternative which is more widely available in the pre-clinic. To study the utility of contrast-enhanced (CE)-CT in GBM xenograft modelling, we optimized CT protocols on two instruments (IVIS-SPECTRUM-CT;TRIUMPH-PET/CT) with/without delivery of contrast. As radiomics analysis may facilitate earlier detection of tumors by CT alone, allowing for deeper analyses of tumor characteristics, we established a radiomic pipeline for extraction and selection of tumor specific CT-derived radiomic features (inc. first order statistics/texture features). U87R-Luc2 GBM cells were implanted orthotopically into NOD/SCID mice (n=25) and tumor growth monitored via weekly BLI. Concurrently mice underwent four rounds of CE-CT (IV iomeprol/iopamidol; 50kV-scan). N=45 CE-CT images were semi-automatically delineated and radiomic features were extracted (Pyradiomics 2.2.0) at each imaging timepoint. Differences between normal and tumor tissue were analyzed using recursive selection. Using either CT instrument/contrast, tumors > 0.4cm3 were not detectable until week-9 post-implantation. Radiomic analysis identified three features (waveletHHH_firstorder_Median, original_glcm_Correlation and waveletLHL_firstorder_Median) at week-3 and -6 which may be early indicators of tumor presence. These features are now being assessed in CE-CT scans collected pre- and post-temozolomide treatment in a syngeneic model of mesenchymal GBM. Nevertheless, BLI is significantly more sensitive than CE-CT (either visually or using radiomic-enhanced CT feature extraction) with luciferase-positive tumors detectable at week-1. In conclusion, U87R-Luc2 tumors > 0.4cm3 are only detectable by Week-8 using CE-CT and either CT instrument studied. Nevertheless, radiomic analysis has defined features which may allow for earlier tumor detection at Week-3, thus expanding the utility of CT in the preclinical setting. Overall, this work supports the discovery of putative prognostic pre-clinical CT-derived radiomic signatures which may ultimately be assessed as early disease markers in patient datasets.

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18F-FDG PET/CT versus Diagnostic Contrast-Enhanced CT for Follow-Up of Stage IV Melanoma Patients Treated by Immune Checkpoint Inhibitors: Frequency and Management of Discordances over a 3-Year Period in a University Hospital

Diagnostics ◽

10.3390/diagnostics11071198 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1198

Author(s):

Jean-Baptiste Le Goubey ◽

Charline Lasnon ◽

Ines Nakouri ◽

Laure Césaire ◽

Michel de Pontville ◽

...

Keyword(s):

Fdg Pet ◽

Stage Iv ◽

Anatomical Site ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Induced Changes

Aim: To perform a comprehensive analysis of discordances between contrast-enhanced CT (ceCT) and 18F-FDG PET/CT in the evaluation of the extra-cerebral treatment monitoring in patients with stage IV melanoma. Materials and methods: We conducted a retrospective monocentric observational study over a 3-year period in patients referred for 18F-FDG PET/CT and ceCT in the framework of therapy monitoring of immune checkpoint (ICIs) as of January 2017. Imaging reports were analyzed by two physicians in consensus. The anatomical site responsible for discordances, as well as induced changes in treatment were noted. Results: Eighty patients were included and 195 pairs of scans analyzed. Overall, discordances occurred in 65 cases (33%). Eighty percent of the discordances (52/65) were due to 18F-FDG PET/CT scans upstaging the patient. Amongst these discordances, 17/52 (33%) led to change in patient’s management, the most frequent being radiotherapy of a progressing site. ceCT represented 13/65 (20%) of discordances and induced changes in patients’ management in 2/13 cases (15%). The most frequent anatomical site involved was subcutaneous for 18F-FDG PET/CT findings and lung or liver for ceCT. Conclusions: Treatment monitoring with 18F-FDG PET/CT is more efficient than ceCT and has a greater impact in patient’s management.

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