CP3 – Improves imaging

Improves imaging: De-CT and textural analysis in comparison with 18-FDG PET/CT, for evaulation of tumor, metastases and lymph nodes in lung cancer.

Michael Bruun Andersen, overlæge, røntgen og skanning, Herlev/Gentofte hospitaler

Status oktober 2022

Project 1: low dose vs high dose CT
The group are working on a project comparing low dose CT with high dose CT with contrast for diagnosing lung cancer. All relevant approvals from the national ethical committee and data authorities were obtained in 2021. We identified and anonymized 600 patients, 300 with and 300 without lung cancer. Currently, roughly 800 of the total 1200 scans have been read. We expect to complete the reading Q1 2023 and be ready for manuscript submission Q3 2023.

Project 2.1: Dual-energy CT compared to FDG PET/CT
Fifty-one patients included retrospectively for comparing FDG uptake within non-small cell lung cancers with dual energy derived iodine enhancement. Twenty-two patients were included for final analysis showing that the two modalities complement each other, as there is no correlation between the FDG and iodine uptake within the same subarea of the tumor. Manuscript has been published in Tomography: “Assessment of Correlation between Dual-Energy Ct (De-Ct)-Derived Iodine Concentration and Local Flourodeoxyglucose (Fdg) Uptake in Patients with Primary Non-Small-Cell Lung Cancer” DOI: 10.3390/tomography8040149

Project 2.2: Photon counting CT compared to FDG PET/CT – with pathological correlation
Currently a study utilizing the results from Project 2.1 are being drafted. This will be conducted on a photon-counting CT system that is next generation CT technology with higher spatial resolution and capabilities to accurately measure fat, calcium and iodine content. The protocol is almost complete and we hope to start patient inclusion in the fall of 2023. This project will be funded mostly through external partners.

Project 3.1: Dual-energy CT vs FDG PET/CT for diagnostic workup
As part of the protocol for project 1 the national ethics committee approved the retrospective use of 300 patients with both dual-energy CT and FDG PET/CT suspected for lung cancer. Currently, we are extracting the imaging data from the relevant systems and we aim at reading the DE-CT recording overall TNM stage with sub variables for both T, N and M stage. This is compared to the performance of FDG PET/CT with the final multidisciplinary decision as reference standard.

Project 3.2: Prospective study of Dual-energy CT performance in diagnostic workup of lung cancer
Work on the protocol has commenced, but will depend on the outcome of project 2.2. We aim at having a complete protocol ready for submission to the ethical committee later this year and hopefully an approval spring 2023. We expect that patients included in project 2.2 will form the basis of this project as well. In both project 3.1 and 3.2 we will compare both dual energy CT/spectral CT, conventional contrast enhanced CT and PET/CT.