From the *Department of Radiology, Boston University School of Medicine, Boston, MA; and †Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD.
Clin Nucl Med. 2013 Oct;38(10):790-4. doi: 10.1097/RLU.0b013e31829f8ca5.
This study aims to determine if the expansion of a PET/CT service to include simultaneous contrast-enhanced CT with PET (PET/DCT) leads to a reduction of supplemental diagnostic CT (sCT) performed within a 6-month period centered around PET/CT for initial treatment planning of patients with head and neck cancers.
There were 91 patients with head and neck cancers who had a non-contrast-enhanced PET/CT with CT (PET/aCT), and 153 patients had a PET/DCT. We compared the utilization of sCT before and after PET/aCT or PET/DCT. Logistic regression analysis, unpaired t test, and analysis of variance were performed.
Among the 75 patients who had sCT scans in the 3 months before their PET/CT, 44 (58.7%) scans were performed in patients who had a PET/aCT and 31 (41.3%) scans were performed in patients who had a PET/DCT (P < 0.001). Among the 36 patients who had a CT in the 3 months after their baseline PET/CT, 23 (63.9%) were performed in patients who had a baseline PET/aCT and 13 (36.1%) were performed in patients who had a baseline PET/DCT (P < 0.001). The adjusted odds ratio for performing an sCT within 3 months before and after baseline PET/DCT scan as opposed to a PET/aCT scan was 0.24 (P < 0.001) and 0.31 (P < 0.01), respectively.
The opportunity to order simultaneous diagnostic CT imaging with PET/CT (PET/DCT) reduced the referrals for stand-alone CT neck imaging in the initial treatment plan of head and neck cancer patients when compared to a service that only offered the PET/CT scan with CT for attenuation correction (PET/aCT).
本研究旨在确定 PET/CT 服务的扩展，包括同时进行对比增强 CT 与 PET（PET/DCT），是否会减少在最初治疗计划中对患者进行头颈部癌症的 PET/CT 扫描前后 6 个月内进行的补充诊断性 CT（sCT）。
有 91 例头颈部癌症患者进行了非增强 PET/CT 与 CT（PET/aCT）扫描，153 例患者进行了 PET/DCT。我们比较了在 PET/aCT 或 PET/DCT 前后 sCT 的使用情况。采用逻辑回归分析、未配对 t 检验和方差分析。
在进行 PET/CT 扫描前的 3 个月内，75 例患者中有 44 例（58.7%）进行了 sCT 扫描，其中 44 例患者进行了 PET/aCT，31 例患者进行了 PET/DCT（P<0.001）。在进行基线 PET/CT 扫描后的 3 个月内，36 例患者中有 23 例（63.9%）进行了 CT 扫描，其中 23 例患者进行了基线 PET/aCT，13 例患者进行了基线 PET/DCT（P<0.001）。与进行 PET/aCT 扫描相比，进行基线 PET/DCT 扫描前后 3 个月内进行 sCT 的调整后比值比分别为 0.24（P<0.001）和 0.31（P<0.01）。
与仅提供衰减校正的 PET/CT 扫描（PET/aCT）相比，在最初治疗计划中对头颈部癌症患者进行同时进行诊断性 CT 成像的机会减少了对单独 CT 颈部成像的转诊。
