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European Radiology

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Open Access 01-10-2020 | Computed Tomography | Oncology

Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients

Authors: Michael Brun Andersen, Dyveke Ebbesen, Jesper Thygesen, Matthijs Kruis, Finn Rasmussen

Published in: European Radiology | Issue 10/2020

Abstract

Objectives

To investigate the diagnostic impact and performance of spectral dual-layer detector CT in the detection and characterization of cancer compared to conventional CE-CT.

Methods

In a national workup program for occult cancer, 503 patients (286 females and 217 males) were prospectively enrolled for a contrast-enhanced spectral CT scan. The readings were performed with and without spectral data available. A minimum of 3 months between interpretations was implemented to minimize recall bias. The sequence of reads for the individual patient was randomized. Readers were blinded for patient identifiers and clinical outcome. Two radiologists with 9 and 33 years of experience performed the readings in consensus. If disagreement, a third radiologist with 11 years of experience determined the outcome of the reading

Results

Significantly more cancer findings were identified on the spectral reading. In 73 cases of proven cancer, we found a sensitivity of 89% vs 77% and a specificity of 77% vs 83% on spectral CT compared to conventional CT. A slight increase in reading time in spectral images of 82 s was found (382 vs 300, p < 0.001). For all cystic lesions, the perceived diagnostic certainty increased from 30% being completely certain to 96% most pronounced in the kidney, liver, thyroid, and ovaries. And adding the spectral information to the reading gave a decrease in follow-up examination for diagnostic certainty (0.25 vs 0.81 per reading, p < 0.001).

Conclusion

The use of contrast-enhanced spectral CT increases the confidence of the radiologists in correct characterization of various lesions and minimizes the need for supplementary examinations.

Key Points

• Spectral CT is associated with a higher sensitivity, but a slightly lower specificity compared to conventional CT.

• Spectral CT increases the confidence of the radiologists.

• The need for supplementary examinations is decreased, with only a slight increase in reading times.

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Title: Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients
Authors: Michael Brun Andersen
Dyveke Ebbesen
Jesper Thygesen
Matthijs Kruis
Finn Rasmussen
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: European Radiology / Issue 10/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06878-7

At a glance: The STEP trials

Springer Medicine

Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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