Universität zu Köln

Lennartz, Simon, Zopfs, David, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Bratke, Grischa, Le Blanc, Markus, Slebocki, Karin, Wagner, Anton, Wybranski, Christian, Wahba, Roger, Maintz, David, Grosse Hokamp, Nils and Persigehl, Thorsten (2020). Iodine overlays to improve differentiation between peritoneal carcinomatosis and benign peritoneal lesions. Eur. Radiol., 30 (7). S. 3968 - 3977. NEW YORK: SPRINGER. ISSN 1432-1084

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Abstract

Objectives Peritoneal carcinomatosis (PC) is a prognostically relevant metastatic disease which may be difficult to depict in postoperative patients, particularly in early stages. This study aimed to determine whether PC could be diagnosed more accurately when using a combination of spectral detector CT (SDCT)-derived conventional images (CI) and iodine overlay images (IO) compared with CI only. Methods Thirty patients with PC and 30 patients with benign peritoneal alterations (BPA) who underwent portal-venous abdominal SDCT were included. Four radiologists determined the presence/absence of PC for each patient and assessed lesion conspicuity, diagnostic certainty, and image quality using 5-point Likert scales. Subjective assessment was conducted in two sessions comprising solely CI and CI/IO between which a latency of 6 weeks was set. Iodine uptake and HU attenuation were determined ROI-based to analyze quantitative differentiation of PC/BPA. Results Specificity for PC was significantly higher when using CI/IO compared with using CI only (0.86 vs. 0.78, p <= 0.05), while sensitivity was comparable (0.79 vs. 0.81, p = 1). In postoperative patients, the increase in specificity was the highest (0.93 vs. 0.80, p <= 0.05). Lesion conspicuity was rated higher in CI/IO (4 (3-5)) compared with that in CI only (3 (3-4); p <= 0.05). Diagnostic certainty was comparable (both 4 (3-5); p = 0.5). CI/IO received the highest rating for overall image quality and assessability (CI/IO 5 (4-5) vs. CI 4 (4-4) vs. IO 4 (3-4); p <= 0.05). Area under the receiver operating characteristics curve (AUC) for quantitative differentiation between PC and BPA was higher for iodine (AUC(Iodine) = 0.95, AUC(HU) = 0.90). Conclusions Compared with CI, combination of CI/IO improves specificity in the assessment of peritoneal carcinomatosis at comparable sensitivity, particularly in postoperative patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Bratke, Grischa UNSPECIFIED UNSPECIFIED UNSPECIFIED Le Blanc, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Slebocki, Karin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagner, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Wybranski, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahba, Roger UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Grosse Hokamp, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-341545
DOI:	10.1007/s00330-020-06729-5
Journal or Publication Title:	Eur. Radiol.
Volume:	30
Number:	7
Page Range:	S. 3968 - 3977
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OVARIAN-CANCER; ENHANCED CT; COMPUTED-TOMOGRAPHY; COLORECTAL ORIGIN; F-18-FDG PET/CT; MRI; DISSEMINATION; METASTASES; PRINCIPLES; INDEX Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34154