Document Detail


Limitations of CT during PET/CT.
MedLine Citation:
PMID:  17873133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our aim was to determine the diagnostic limitations of low-dose, unenhanced CT scans performed for anatomic reference and attenuation correction during PET/CT. METHODS: The Radiology Information System at our oncologic hospital was queried during the 9-mo period from July 2002 to April 2003 for patients with PET/CT scans and diagnostic enhanced CT within 2 wk of each other. One radiologist interpreted the CT portion of the PET/CT (CT(p)) unaware of the PET results and the associated enhanced diagnostic CT (CT(d)). A medical student compared this interpretation with the official report of the CT(d) and listed all discrepancies between reports. A separate radiologist compared CT(p) and CT(d) images and classified true discrepant findings as due to lack of intravenous contrast, arm-position artifact, lack of enteric contrast, low milliamperage (mA), and quality of lung images. RESULTS: Among 100 patients, the most common malignancies were lymphoma (n = 37), cancer of the colorectum (n = 31), and esophageal cancer (n = 15). Among 194 true discrepancies in which findings were missed at CT(p), causes were as follows: (a) lack of intravenous contrast (128/194, 66%), (b) arm-down artifact (17/194, 9%), (c) quality of lung images (26/194, 13%), (d) lack of enteric contrast (15/194, 8%), and (e) low mA (8/194, 4%). Discrepancies were seen most commonly in detecting lymphadenopathy and visceral metastases. CONCLUSION: Most missed findings on the unenhanced CT portion of the PET/CT scans were due to technical factors that could be altered. Discrepant findings would have led to altered management in only 2 patients, suggesting a role for limited repeat imaging to reduce radiation and use of valuable resources.
Authors:
Marc J Gollub; Richard Hong; Debra M Sarasohn; Tim Akhurst
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2007-09-14
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  48     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-02     Completed Date:  2007-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1583-91     Citation Subset:  IM    
Affiliation:
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. gollubm@mskcc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms*
Child
Child, Preschool
Humans
Image Enhancement / methods*
Image Interpretation, Computer-Assisted / methods*
Middle Aged
Neoplasms / diagnosis*
Observer Variation
Positron-Emission Tomography / methods*
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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