Purpose: The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18FâFDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. Methods: Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3DâPET/CT and liver 4DâPET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4DâPET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4DâPET/CT. Results: Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3DâPET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4DâPET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4DâPET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4DâPET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4DâPET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3DâPET (mean ± SD, 5.2 ± 2.3). Conclusions: Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic accuracy, and confidence in reporting. 4DâPET/CT also improved the quantification of SUVmax of liver lesions.
Added diagnostic value of respiratory-gated 4D 18Fâ FDG PET/CT in the detection of liver lesions: a multicenter study / Crivellaro, Cinzia; De Ponti, Elena; Elisei, Federica; Morzenti, Sabrina; Picchio, Maria; Bettinardi, Valentino; Versari, Annibale; Fioroni, Federica; Dziuk, Miroslaw; Tkaczewski, Konrad; Ahond-Vionnet, Renée; Nodari, Guillaume; Todde, Sergio; Landoni, Claudio; Guerra, Luca. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - 45:1(2018), pp. 102-109. [10.1007/s00259-017-3795-0]
Added diagnostic value of respiratory-gated 4D 18FâFDG PET/CT in the detection of liver lesions: a multicenter study
Picchio, Maria;
2018-01-01
Abstract
Purpose: The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18FâFDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. Methods: Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3DâPET/CT and liver 4DâPET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4DâPET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4DâPET/CT. Results: Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3DâPET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4DâPET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4DâPET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4DâPET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4DâPET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3DâPET (mean ± SD, 5.2 ± 2.3). Conclusions: Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic accuracy, and confidence in reporting. 4DâPET/CT also improved the quantification of SUVmax of liver lesions.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
