title: Clinical impact of contrast-enhanced computed tomography combined with low-dose (18)F-fluorodeoxyglucose positron emission tomography/computed tomography on routine lymphoma patient management.
abstract: This study evaluated the clinical impact of contrast-enhanced computed tomography (CECT) on routine management of patients with lymphoma. Over a 1-year period, 237 CECT scans were performed prospectively in 163 patients after low-dose (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT). Scans were performed at staging (n = 41), interim (n = 73), post-therapy (n = 115) and follow-up (n = 8). Clinical impact was determined from the multidisciplinary committee reports. CECT had no clinical impact in 219 cases (92%). A clear impact was noted in only 3%, i.e. up-staging of lymphoma (n = 2) and diagnosis of deep vein thrombosis (n = 5). A debatable impact was noted in the remaining 11 cases, consisting of additional investigations, either without therapeutic impact (n = 8), or resulting in delay of therapy onset (n = 2) or ablative surgery (n = 1). CECT delivered an average 33.5 ± 3.8 mSv vs. 17.7 ± 2.8 mSv for PET/CT. In conclusion, the clinical impact of CECT seems limited, although scarce, life-threatening conditions were diagnosed. Imaging of lymphoma needs optimization to reduce radiation exposure.
authors.affiliation: Department of Nuclear Medicine, Henri Mondor Hospital and Paris-Est University , Créteil , France.
authors.forename: Julia
authors.initials: J
authors.lastname: Chalaye
authors.forename: Alain
authors.initials: A
authors.lastname: Luciani
authors.forename: Catalina
authors.initials: C
authors.lastname: Enache
authors.forename: Pauline
authors.initials: P
authors.lastname: Beaussart
authors.forename: Catherine
authors.initials: C
authors.lastname: Lhermite
authors.forename: Eva
authors.initials: E
authors.lastname: Evangelista
authors.forename: Myriam
authors.initials: M
authors.lastname: Sasanelli
authors.forename: Violaine
authors.initials: V
authors.lastname: Safar
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Alain
authors.initials: A
authors.lastname: Rahmouni
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Itti
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D019468:Disease Management; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008223:Lymphoma / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18
keywords: Contrast-enhanced CT; low-dose PET/CT; lymphoma; patient management; radiation exposure