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.
Ansvarlig/responsible:
Michael Bruun Andersen, overlæge, røntgen og skanning, Herlev/Gentofte hospitaler
Status december 2024
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. All 1200 scans have been read and the statistical analysis plan has been carried out. Currently the manuscript is being drafted.
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
The study protocol has been approved at the ethical committee and is scheduled to include patients within the last 3 months of 2024. Patients referred for surgery at Rigshospitalet Copenhagen will be included and scanned on the photon-counting CT system with higher spatial resolution and capabilities to accurately measure fat, calcium and iodine content. Initially 20 patients will be included to test the feasibility. In case that is successful a total of 100 patients will be included over the course of 2025 which will be funded by external means.
Project 3.1: Photon-counting CT vs FDG PET/CT for diagnostic workup
We are currently recruiting patients for study 3 prospectively. The protocol has been approved by the ethical committee. Currently a total of 170 patients are included with roughly 10% having lung cancer. A total of 1000 patients will be included in the project, and we expect final inclusion in Q3 2025. Furthermore, to increase the number of patients with lung cancer a separate recruiting pathway is being explored where patients referred to PET/CT with imaging from other sites will be scanned at the photon-counting scanner at Herlev to reach a total of 3-400 patients with lung cancer scanned on photon-counting CT, FDG PET/CT and conventional CT. We aim to investigate the combination of modalities for determining T, N and M stages comparing the performance to FDG PET/CT and the final multidisciplinary decision will serve as reference standard.
Project 3.2: Prospective study of photon-counting CT performance in diagnostic workup of lung cancer
Actively recruiting patients and currently a total of 170 patients have been included. All patients have been prospectively read with a structured report. Will determine the impact of photon-counting CT on primary diagnoses and the number of additional follow-up examinations needed in a prospective setting.