title: Contrast-enhanced [18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in clinical oncology: tumor-, site-, and question-based comparison with standard positron emission tomography/computed tomography.
abstract: BACKGROUND
  The present study aimed to evaluate the added value of contrast-enhanced computed tomography (ceCT) in comparison to standard, non-enhanced CT in the context of a combined positron emission tomography (PET)/CT examination by means of a tumor-, site-, and clinical question-based approach.
  
  
  METHODS
  Analysis was performed in 202 patients undergoing PET/CT consisting of a multiphase CT protocol followed by a whole-body PET. The Cochran Q test was performed, followed by a multiple comparisons correction (McNemar test and Bonferroni adjustment), to compare standard and contrast-enhanced PET (cePET/CT). Histopathology or clinical-radiologic follow-up greater than 1 year was used as a reference.
  
  
  RESULTS
  cePET/CT showed significantly different results with respect to standard PET/CT in head and neck and gastrointestinal cancer (P = 0.02 and 0.0002, respectively), in the evaluation of lesions located in the abdomen (P = 0.009), and in the context of disease restaging (P = 0.003). In all these clinical scenarios, adding ceCT resulted in a distinct benefit, by yielding a higher percentage of change in patient management.
  
  
  CONCLUSIONS
  These data strongly underline the importance of strictly selecting patients for the combined exam. In particular, patient selection should not be driven solely by mere tumor classification, but should also account for the clinical question and the anatomical location of the neoplastic disease, which can significantly impact patient management.
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.forename: Raffaella
authors.initials: R
authors.lastname: Conzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Campus
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cittadini
authors.forename: Irene
authors.initials: I
authors.lastname: Bossert
authors.forename: Michela
authors.initials: M
authors.lastname: Massollo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fornarini
authors.forename: Iolanda
authors.initials: I
authors.lastname: Calamia
authors.forename: Cecilia
authors.initials: C
authors.lastname: Marini
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiz
authors.forename: Chiara
authors.initials: C
authors.lastname: Ghersi
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Derchi
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D018579:Patient Selection; D049268:Positron-Emission Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18