title: FDG PET and Split-Bolus Multi-Detector Row CT Fusion Imaging in Oncologic Patients: Preliminary Results.
abstract: OBJECTIVE
  To assess the incremental value of split-bolus multidetector computed tomography (CT) combined with fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for follow-up of oncologic patients.
  
  
  METHODS
  The institutional ethics committee approved the use of this protocol. Thirty-eight oncologic patients who underwent FDG PET/unenhanced multidetector CT and split-bolus multidetector CT for restaging were investigated retrospectively. The split-bolus CT protocol included imaging during the hepatic arterial and portal venous phases in one scan. Software was used for fusion of the independently acquired FDG PET and split-bolus CT data, and fused datasets were compared with FDG PET/unenhanced CT data. The standard of reference for diagnosis of lesions in all patients was a combination of histologic results (if available), clinical results (medical history, physical examination, and laboratory test results), and the results of follow-up imaging (conventional CT, magnetic resonance imaging, and/or ultrasonography) for at least 6 months. Descriptive statistics were used.
  
  
  RESULTS
  Fifty-nine true-positive lesions were identified with fused FDG PET/split-bolus CT; 41 were concordant and detected with both split-bolus CT and PET/unenhanced CT, 16 with split-bolus CT only, and two with PET/unenhanced CT. Two different false-positive lesions were identified with PET/unenhanced CT and PET/split-bolus CT. Furthermore, in 20 of 38 (53%) patients, FDG PET/split-bolus CT allowed detection of important additional findings (n = 40) not detected at FDG PET/unenhanced CT. Both the tumor-related findings (n = 13, 32.5%) and the non-tumor-related findings (n = 27, 67.5%) were important to the clinical treatment of these patients.
  
  
  CONCLUSIONS
  Fused FDG PET/split-bolus multidetector CT provides additional information compared with FDG PET/unenhanced multidetector CT in oncologic patients.
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Michele
authors.initials: M
authors.lastname: Scialpi
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Isabella
authors.initials: I
authors.lastname: Palumbo
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Sabrina
authors.initials: S
authors.lastname: Gravante
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Tommaso
authors.initials: T
authors.lastname: Buresta
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Alfredo
authors.initials: A
authors.lastname: D'Andrea
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Luisa
authors.initials: L
authors.lastname: Pierotti
authors.affiliation: From the Department of Surgical and Biomedical Sciences, Division of Radiology 2 (M.S., S.G., L.P.), Department of Surgical and Biomedical Sciences (I.P.), and Department of Surgical and Biomedical Sciences, Division of Nuclear Medicine (T.B., B.P.), Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, 06134 Perugia, Italy; and Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy (A.D.).
authors.forename: Barbara
authors.initials: B
authors.lastname: Palumbo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D007479:Iopamidol / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007472:Iohexol; C038192:iopromide; D007479:Iopamidol