title: PET-CT and diagnostic CT: the synergy of metabolic and morphological data in onco-haematology.
abstract: OBJECTIVE
  Our goal was to determine how interpreting diagnostic CT together with PET-CT could improve the assessment of morphology in onco-haematology.
  
  
  METHODS
  Fifty-nine patients with aggressive lymphoma were retrospectively included. The diagnostic CT scan was interpreted by two radiologists, followed by a combined analysis of the CT and the PET-CT carried out by two specialists in metabolic and morphological imaging. The diagnostic performances were assessed in terms of sensitivity and specificity, then concordance and discordance rates (kappa) were studied.
  
  
  RESULTS
  A combined interpretation of CT and PET-CT showed better diagnostic performances than those of interpretations of CT only in the assessment of nodal sites (826 sites, sensitivity of 99% versus 85%, P<0.05), extranodal sites (649 sites, sensitivity of 88% versus 78%) and bone sites (one analysed per patient, sensitivity of 50% versus 27%). The combined interpretation also improved inter-observer agreement and led to an upgraded Ann Arbor staging in 15% of patients, with a change of treatment in 10%.
  
  
  CONCLUSIONS
  Interpretation of diagnostic CT in onco-haematology can be improved by combining it with an assessment of PET-CT. The synergy between metabolic and morphological information leads to improved diagnostic capabilities and renders interpretations more reproducible.
authors.affiliation: University of Lyon, Faculty of Medicine, EA 3738, UCB Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France. Electronic address: fabienricard@aliceadsl.fr.
authors.forename: F
authors.initials: F
authors.lastname: Ricard
authors.affiliation: University of Lyon, Faculty of Medicine, EA 3738, UCB Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Giammarile
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Tychyj-Pinel
authors.affiliation: University of Lyon, Faculty of Medicine, EA 3738, UCB Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Houzard
authors.affiliation: University of Lyon 1, 69003 Lyon, France; University of Lyon, EA santé-individu-société, 69003 Lyon, France; Hospices Civils de Lyon, IMER Unit, 162, avenue Lacassagne, 69003 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Chateau
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: A F
authors.initials: AF
authors.lastname: Manichon
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Orliaguet
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Haematology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Michallet
authors.affiliation: University of Lyon 1, 69003 Lyon, France; Hospices Civils de Lyon, Lyon South General Hospital, Haematology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Salles
authors.affiliation: University of Lyon, Faculty of Medicine, EA 3738, UCB Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: P J
authors.initials: PJ
authors.lastname: Valette
authors.affiliation: Hospices Civils de Lyon, Lyon South General Hospital, Nuclear Medicine and Radiology Department, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Réty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D003299:Cooperative Behavior; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted; D033183:Interdisciplinary Communication; D007472:Iohexol / Q000031:analogs & derivatives; D008198:Lymph Nodes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000503:physiopathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: C093233:iobitridol; D007472:Iohexol
keywords: CT; Haematology; Lymphoma; Positron emission tomography