Universität zu Köln

Voltin, Conrad-Amadeus ORCID: 0000-0002-5437-3959, Mettler, Jasmin, Boellaard, Ronald ORCID: 0000-0002-0313-5686, Kuhnert, Georg, Dietlein, Markus, Borchmann, Peter, Drzezga, Alexander and Kobe, Carsten (2019). Quantitative assessment of F-18-FDG PET in patients with Hodgkin lymphoma: is it significantly affected by contrast-enhanced computed tomography attenuation correction? Nucl. Med. Commun., 40 (3). S. 249 - 258. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5628

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Abstract

Objective The reliability of visual and quantitative response assessment may be impaired owing to inconsistent scanning protocols and image reconstruction methods of 2-deoxy-2-[F-18]fluoro-d-glucose (F-18-FDG) PET. Hence, this study investigates the effect of contrast-enhanced computed tomography (CT) attenuation correction in patients with Hodgkin lymphoma. Patients and methods In 10 consecutive patients undergoing either staging or response assessment, F-18-FDG PET images were attenuation-corrected once on the basis of unenhanced CT and additionally using contrast-enhanced CT. Reconstruction was performed in both cases with ordered subset expectation maximization (OSEM) and ultra-high definition (UHD) algorithm. While maximum and peak standardized uptake value (SUV) were obtained from tumour tissue (lesionSUV(max) and lesionSUV(peak)), maximum and mean SUVs were determined within the background regions liver (liverSUV(max) and liverSUV(mean)) and mediastinal blood pool (mbpSUV(max) and mbpSUV(mean)). Results After switching to contrast-enhanced CT attenuation correction, lesionSUV(max) and lesionSUV(peak) increased on average by 2.55 +/- 3.24 (P=0.018) and 3.64 +/- 3.22% (P=0.008), respectively, with OSEM and by 4.59 +/- 5.49 (P=0.005) and 3.84 +/- 5.65% (P=0.005), respectively, with UHD reconstruction. LiverSUV(max) and liverSUV(mean) showed a mean rise of 7.15 +/- 4.27 (P=0.005) and 6.97 +/- 2.18% (P=0.005), respectively, in the OSEM data sets and of 7.24 +/- 6.59 (P=0.017) and 6.29 +/- 2.83% (P=0.005), respectively, in the UHD images. The average increases of mbpSUV(max) and mbpSUV(mean) were 10.82 +/- 4.89 (P=0.005) and 12.40 +/- 3.73% (P=0.005), respectively, after OSEM, compared with 13.11 +/- 14.93 (P=0.005) and 11.50 +/- 12.19% (P=0.005), respectively, after UHD reconstruction. Conclusion As the use of CT contrast fluids results in a stronger SUV increase within the liver and mediastinal blood pool than within lymphoma tissue, this may have clinical consequences regarding visual and quantitative response assessment. Ideally, CT scans for PET attenuation correction should therefore be performed in the absence of a contrast agent.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Voltin, Conrad-Amadeus UNSPECIFIED orcid.org/0000-0002-5437-3959 UNSPECIFIED Mettler, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Boellaard, Ronald UNSPECIFIED orcid.org/0000-0002-0313-5686 UNSPECIFIED Kuhnert, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietlein, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-155610
DOI:	10.1097/MNM.0000000000000956
Journal or Publication Title:	Nucl. Med. Commun.
Volume:	40
Number:	3
Page Range:	S. 249 - 258
Date:	2019
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5628
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language B-CELL LYMPHOMA; INTRAVENOUS CONTRAST; UNENHANCED CT; INTERIM-PET; SUV; LIVER; CRITERIA; THERAPY; IMPACT; TUMOR Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15561