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Diagnosis of neuroendocrine tumours by retrospective image fusion: is there a benefit?

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

This study evaluated the use of image fusion in the preoperative staging of neuroendocrine tumors (NET) of the pancreas and the gastrointestinal tract (GIT). Thirty-eight patients suffering from a metastasized NET with location of the primary in the pancreas (n=15) or the GIT (n=23) were examined by somatostatin receptor scintigraphy (SRS) and computed tomography (CT). Consecutive image registration and fusion were performed using custom-built software integrated in AVS/Express (Advanced Visual Systems, Waltham, MA, USA). Registration was performed by a voxel-based algorithm based on normalized mutual information. Image fusion was feasible in 36/38 patients. A total of 87 foci were assigned to anatomical regions (e.g. gut, pancreas, liver, lymph node or others) by two independent observers in both SRS and SRS/CT fusion images. The assignments used a binary ranking system (1=”definite”, 0=”not definite”). These results were then retrospectively compared to the classification of the foci, based on postoperative histology or clinical follow-up. Imaging by SRS allowed a definite anatomical assignment in 57% (50/87) and 61% (53/87) of all lesions in the case of observers A and B, respectively. Image fusion improved the topographic assignment to 91% (79/87) and to 93% (81/87). The number classified as “definite” by both observers increased from 54% (47/87) to 86% (77/87). The increase in definite assignments was highly significant for both observers (P<0.0001 for each). In the case of foci classified as liver metastases, image fusion allowed improved assignment to the corresponding liver segment from 45% (18/40) to 98% (39/40) and from 58% (23/40) to 100% (40/40) by observers A and B, respectively. Furthermore, the improved assignment of foci classified as lesions by image fusion was relevant for therapy in 7/36 patients (19%). Therefore, the image fusion technique presented herein appears to be a very useful method for clinical routine.

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Acknowledgements

This study was supported by Deutsche Forschungsgemeinschaft as part of the project Graduiertenkolleg 331: “Temperaturabhängige Effekte in Therapie und Diagnostik” (Grant No. GRK331–1/97). T.R. was supported by the National Science Foundation (USA) under Grant No. EIA-0104114.

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Authors and Affiliations

  1. Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    H. Amthauer, J. Ruf, E. Lopez-Hänninen, M. Gutberlet, A.-J. Lemke & R. Felix

  2. Klinik für Hepatologie, Gastroenterologie, Endokrinologie und Stoffwechsel, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany

    M. Böhmig, U. Plöckinger & B. Wiedenmann

  3. Klinik für Allgemein- und Transplantationschirurgie, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany

    T. Steinmüller

  4. Image Guidance Laboratories, Department of Neurosurgery, Stanford University, USA

    T. Rohlfing

  5. Institut für Medizinische Biometrie, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany

    K-D. Wernecke

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  1. H. Amthauer
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  2. J. Ruf
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  4. E. Lopez-Hänninen
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  5. T. Rohlfing
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  6. K-D. Wernecke
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  7. U. Plöckinger
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  8. M. Gutberlet
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  9. A.-J. Lemke
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  10. T. Steinmüller
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  11. B. Wiedenmann
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  12. R. Felix
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Correspondence to H. Amthauer.

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Amthauer, H., Ruf, J., Böhmig, M. et al. Diagnosis of neuroendocrine tumours by retrospective image fusion: is there a benefit?. Eur J Nucl Med Mol Imaging 31, 342–348 (2004). https://doi.org/10.1007/s00259-003-1379-7

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  • DOI: https://doi.org/10.1007/s00259-003-1379-7

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