Universität zu Köln

Nelles, Christian ORCID: 0000-0002-7351-7516, Rauen, Philip ORCID: 0000-0002-3849-6537, Meyer, Franziska, Dobrostal, Anja, Niederau, Pia Lena, Zaytoun, Hasan ORCID: 0000-0003-1025-2087, Weisthoff, Mathilda ORCID: 0000-0001-6536-3898, Bernard, Pascale, Heneweer, Carola, Dratsch, Thomas ORCID: 0000-0003-4014-7763, Maintz, David ORCID: 0000-0002-8942-3776, Kottlors, Jonathan ORCID: 0000-0001-5021-6895, Kreuzberg, Nicole, Große Hokamp, Nils ORCID: 0000-0001-7928-0487, Zopfs, David ORCID: 0000-0001-9978-7453, Persigehl, Thorsten ORCID: 0000-0001-5928-4405 and Lennartz, Simon ORCID: 0000-0001-7202-398X (2025). Spectral CT imaging for assessment of metastases in melanoma patients: multi-reader evaluation. Cancer Imaging, 25 (1). pp. 1-11. Springer Nature. ISSN 1470-7330

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Abstract

[Artikel-Nr.: 74] Background: Pilot studies have indicated diagnostic benefits from using dual-energy CT (DECT) for staging and follow-up of melanoma patients. The purpose of this study was to investigate the sensitivity, specificity and qualitative assessment of spectral image reconstructions for metastases in melanoma patients in a large-scale, multi-reader evaluation. Methods: In total, 308 patients with melanoma, 95 patients with metastases and a control group of 213 patients without metastases, who underwent oncologic staging CT of the chest, abdomen and pelvis on a dual-layer dual-energy CT system (dlDECT) were retrospectively included. Conventional images (CI), color-coded iodine overlays (IO) and virtual monoenergetic images at 40 keV (VMI 40keV ) were reconstructed. 6 radiologists (3 experienced with 6 to 9 years and 3 less experienced with 2 to 4 years of experience) read all cases in a CI-based session, and a session based on a combination of CI, IO and VMI 40keV . Readers were asked to determine presence of metastases in specific tissues in a binary fashion and to indicate diagnostic certainty and lesion delineation on 5-point Likert scales. Results: Sensitivity for detection of metastases in the skeletal muscle and peritoneum was significantly higher for the spectral assessment (for skeletal muscle 70% vs. 61%; for peritoneum 76% vs. 62%, both: p < 0.05). For subcutaneous metastases, there was a significant increase in specificity (92% vs. 89%, p < 0.05), however accompanied with a significant decrease in sensitivity (79% vs. 85%, p < 0.05). Diagnostic certainty was rated significantly higher for spectral images than CI in all (6/6) of the assessed tissues, whereas improvements in lesion delineation were noted for the skeletal muscle, the subcutaneous tissue and the pancreas. Conclusions: We found that in melanoma patients, the benefit of dlDECT-derived spectral reconstructions depends on the assessed tissue. While assessment of skeletal muscle and peritoneal metastases was significantly improved, low or absent iodine uptake of subcutaneous lesions led to false negatives and a consecutive decrease in sensitivity.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Nelles, Christian UNSPECIFIED https://orcid.org/0000-0002-7351-7516 UNSPECIFIED Rauen, Philip UNSPECIFIED https://orcid.org/0000-0002-3849-6537 UNSPECIFIED Meyer, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Dobrostal, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederau, Pia Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaytoun, Hasan UNSPECIFIED https://orcid.org/0000-0003-1025-2087 UNSPECIFIED Weisthoff, Mathilda UNSPECIFIED https://orcid.org/0000-0001-6536-3898 UNSPECIFIED Bernard, Pascale UNSPECIFIED UNSPECIFIED UNSPECIFIED Heneweer, Carola UNSPECIFIED UNSPECIFIED UNSPECIFIED Dratsch, Thomas UNSPECIFIED https://orcid.org/0000-0003-4014-7763 UNSPECIFIED Maintz, David UNSPECIFIED https://orcid.org/0000-0002-8942-3776 UNSPECIFIED Kottlors, Jonathan UNSPECIFIED https://orcid.org/0000-0001-5021-6895 UNSPECIFIED Kreuzberg, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED Große Hokamp, Nils UNSPECIFIED https://orcid.org/0000-0001-7928-0487 UNSPECIFIED Zopfs, David UNSPECIFIED https://orcid.org/0000-0001-9978-7453 UNSPECIFIED Persigehl, Thorsten UNSPECIFIED https://orcid.org/0000-0001-5928-4405 UNSPECIFIED Lennartz, Simon UNSPECIFIED https://orcid.org/0000-0001-7202-398X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-801453
Identification Number:	10.1186/s40644-025-00889-7
Journal or Publication Title:	Cancer Imaging
Volume:	25
Number:	1
Page Range:	pp. 1-11
Number of Pages:	11
Date:	16 June 2025
Publisher:	Springer Nature
ISSN:	1470-7330
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Dermatologie > Klinik und Poliklinik für Dermatologie und Venerologie Faculty of Medicine > Radiologische Diagnostik > Institut und Poliklinik für Radiologische Diagnostik Faculty of Medicine > Weitere > Centrum für integrierte Onkologie (CIO)
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Melanoma ; Metastases ; Dual-energy computed tomography ; Staging English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80145