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

被引:24
作者
Amthauer, H
Ruf, J
Böhmig, M
Lopez-Hänninen, E
Rohlfing, T
Wernecke, KD
Plöckinger, U
Gutberlet, M
Lemke, AJ
Steinmüller, T
Wiedenmann, B
Felix, R
机构
[1] Charite Univ Med Berlin, Klin Strahlenheilkunde, D-13353 Berlin, Germany
[2] Charite Univ Med Berlin, Klin Hepatol Gastroenterol Endokrinol & Stoffwech, Berlin, Germany
[3] Charite Univ Med Berlin, Klin Allgemein & Transplantat Chirurg, Berlin, Germany
[4] Stanford Univ, Dept Neurosurg, Image Guidance Labs, Stanford, CA 94305 USA
[5] Charite Univ Med Berlin, Inst Med Biometrie, Berlin, Germany
基金
美国国家科学基金会;
关键词
neuroendocrine tumors; somatostatin receptor scintigraphy; computed tomography; image registration; image fusion;
D O I
10.1007/s00259-003-1379-7
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
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.
引用
收藏
页码:342 / 348
页数:7
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