Universität zu Köln

Zopfs, David, Hokamp, Nils Grosse, Reimer, Robert, Bratke, Grischa, Maintz, David, Bruns, Christiane, Mallmann, Christoph, Persigehl, Thorsten, Haneder, Stefan and Lennartz, Simon (2021). Value of spectral detector CT for pretherapeutic, locoregional assessment of esophageal cancer. Eur. J. Radiol., 134. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: To investigate the diagnostic value of spectral detector dual-energy CT-derived low-keV virtual monoenergetic images (VMI) and iodine overlays (IO) for locoregional, pretherapeutic assessment of esophageal cancer. Method: 74 patients with biopsy-proven esophageal cancer who underwent pre-therapeutic, portal-venous-phase staging examinations of the chest and abdomen were retrospectively included. Quantitative image analysis was performed ROI-based within the tumor, healthy esophageal wall, peri-esophageal lymph nodes, azygos vein, aorta, liver, diaphragm, and mediastinal fat. Two radiologists evaluated delineation of the primary tumor and locoregional lymph nodes, assessment of the celiac trunk and diagnostic certainty regarding tumor infiltration in conventional images (CI), VMI from 40 to 70 keV and IO. Moreover, presence/absence of advanced tumor infiltration (T3/T4) was determined binary using all available images. Results: VMI40-60keV showed significantly higher attenuation and signal-to-noise ratio compared to CI for all assessed ROIs, peaking at VMI40keV (p < 0.05). Contrast-to-noise ratio of tumor/esophagus (VMI40keV/CI: 7.7 + 4.7 vs. 2.3 +/- 1.5), tumor/diaphragm (VMI40keV/CI: 9.0 +/- 5.5 vs. 2.2 +/- 1.7) and tumor/liver (4.3 +/- 5.5 vs. 1.9 +/- 2.1) were all significantly higher compared to CI (p < 0.05). Qualitatively, lymph node delineation and diagnostic certainty regarding tumor infiltration received highest ratings both in IO and VMI40keV, whereas vascular assessment was rated highest in VMI40keV and primary tumor delineation in 10. Sensitivity/Specificity/ Accuracy for detecting advanced tumor infiltration using the combination of CI, VMI40-70keV and IO was 42.4 %/82.0 %/56.3 %. Conclusions: I0 and VMI40-60keV improve qualitative assessment of the primary tumor and depiction of lymph nodes and vessels at pretherapeutic SDCT of esophageal cancer patients yet do not mitigate the limitations of CT in determining tumor infiltration.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Reimer, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Bratke, Grischa UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallmann, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Haneder, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-581954
DOI:	10.1016/j.ejrad.2020.109423
Journal or Publication Title:	Eur. J. Radiol.
Volume:	134
Date:	2021
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; DUAL-ENERGY CT; COMPUTED-TOMOGRAPHY; IODINE QUANTIFICATION; CELL CARCINOMA; ACCURACY; RECONSTRUCTIONS; STENOSIS Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58195