Contrast enhancement technique for dynamic hepatic computed tomographic scanning.

Foley, W D; Berland, Lincoln L.; Lawson, T L; Smith, D F; Thorsen, M K

doi:10.1148/radiology.147.3.6844616

Cited by 111 publications

(49 citation statements)

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“…When PET-CT was performed without intravenous or oral contrast agents, PET-CT and contrast-enhanced CT provided comparable information regarding hepatic metastases of colorectal cancer, whereas PET-CT was superior in the detection of recurrent intrahepatic metastases after hemihepatectomy. The authors speculated that PET-CT with intravenous contrast would improve the sensitivity even further, as was the case for CT. 29,30 However, there still seems to be a significant number of patients with undetected metastases, because many patients will have recurrent disease at follow-up.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG‐PET‐CT

Wildi

Gubler

Hany

et al. 2007

J of Clinical Ultrasound

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Background. Combined fluorine 18-fluorodeoxyglucose-positron emission tomography-CT imaging has been shown to be of good diagnostic value in the preoperative evaluation of patients with colorectal cancer and liver metastases. The adjunctive use of intraoperative sonography (IOUS) may have a limited impact on treatment selection in these patients.Purpose. To compare the diagnostic performance of preoperative positron emission tomography (PET)-CT alone and PET-CT combined with IOUS in the evaluation of patients who are considered for curative resection of hepatic metastases from colorectal carcinoma.Materials and Methods. Patients with colorectal cancer who underwent resection of hepatic metastases and preoperative PET-CT (with or without contrast-enhanced CT) and IOUS were identified. The performance of the imaging techniques was evaluated through review of the radiologic reports, correlation with surgical and histopathologic findings, and clinical follow-up.Results. Thirty-one patients (mean age, 63.5 years [range, 53-82 years]) were analyzed. Fifteen patients had received preoperative chemotherapy. The mean interval between PET-CT and IOUS was 22.6 days (range, 1-56 days). In 4 cases, neither PET-CT nor IOUS correctly diagnosed the liver metastases. In all 31 patients, the sensitivity of PET-CT alone and PET-CT combined with IOUS was 63% (95% CI 44-80%) and 93% (95% CI 78-98%), respectively; the positive predictive value was 81% and 89%, respectively. In patients without preoperative chemotherapy (n 5 16), the sensitivity of PET-CT alone and PET-CT combined with IOUS was 77% (95% CI 49-94%) and 100% (95% CI 79-100%), respectively. In 11 cases (35%), IOUS altered the surgical strategy.Conclusion. In patients with colorectal carcinoma and potentially resectable liver metastases on preoperative PET-CT, IOUS can provide additional information that may alter decision making with regard to surgical technique. Keywords: colorectal cancer; liver metastases; intraoperative sonography; FDG-PET-CT C olorectal cancer is the second leading cause of cancer-related death in the western hemisphere. Up to 70% of patients with colorectal cancer eventually develop liver metastases. In 30-40% of these patients, metastases are confined to the liver at the time of detection. Hepatic resection is the only therapeutic strategy that offers a chance of cure. In patients who undergo successful hepatic resection with curative intent, the expected 5-year survival rate is approximately 33%, and the 5-year disease-free survival rate is 22%. 1 A large number of patients develop intraor extrahepatic tumor recurrence after curative

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Section: Discussionmentioning

confidence: 99%

Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG‐PET‐CT

Wildi

Gubler

Hany

et al. 2007

J of Clinical Ultrasound

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“…All patients were studied with incremental dynamic scanning both during and after a 2-mm IV injection of iodinated contrast medium (30-42 g of iodine) [2]. Either a GE 9800 or a Philips TX6O was used, and contiguous 1 -cm-thick slices were obtained.…”

Section: Methodsmentioning

confidence: 99%

Hepatic perivascular lymphedema: CT appearance

Koslin

Stanley

Berland

et al. 1988

American Journal of Roentgenology

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“…The purpose of our study, however, was to compare unknown versus known lesion location rather than the absolute accuracy of the optimization process. Secondly, we only considered lesions with density 10 HU lower than that of the background; nevertheless, while lesions with greater difference in density or with higher density to background may have presented different results, a 10-HU density difference represents the minimum lesion-to-liver contrast necessary for detection [24,25]. Finally, the study was performed on one scanner, and care must be exercised in extrapolating these results to other scanner models.…”

Section: Discussionmentioning

confidence: 99%

Optimization of Computed Tomography Protocols: Limitations of a Methodology Employing a Phantom with Location-Known Opacities

et al. 2013

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This study aimed to determine if phantom-based methodologies for optimization of hepatic lesion detection with computed tomography (CT) require randomization of lesion placement and inclusion of normal images. A phantom containing fixed opacities of varying size (diameters, 2.4, 4.8, and 9.5 mm) was scanned at various exposure and slice thickness settings. Two image sets were compared: All images in the first image set contained opacities with known location; the second image set contained images with opacities in random locations. Following Institutional Review Board approval, nine experienced observers scored opacity visualization using a 4-point confidence scale. Comparisons between image sets were performed using Spearman, Kappa, and Wilcoxon techniques. Observer scores demonstrated strong correlation between both approaches when all opacity sizes were combined (r=0.92, p<0.0001), for the 9.5 mm opacity (r=0.96, p<0.0001) and for the 2.4 mm opacity (r=0.64, p<0.05). There was no significant correlation for the 4.8 mm opacity. A significantly higher sensitivity score for the known compared with the unknown location was found for the 9.5 mm opacity and 4.8 mm opacity for a single slice thickness and exposure condition (p<0.05). Phantom-based optimization of CT hepatic examinations requires randomized lesion location when investigating challenging conditions; however, a standard phantom with fixed lesion location is suitable for the optimization of routine liver protocols. The development of more sophisticated phantoms or methods than those currently available is indicated for the optimization of CT protocols for diagnostic tasks involving the detection of subtle change.

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Contrast enhancement technique for dynamic hepatic computed tomographic scanning.

Cited by 111 publications

References 0 publications

Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG‐PET‐CT

Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG‐PET‐CT

Hepatic perivascular lymphedema: CT appearance

Optimization of Computed Tomography Protocols: Limitations of a Methodology Employing a Phantom with Location-Known Opacities

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