ArticleCancer imaging : the official publication of the International Cancer Imaging Society2025
Spectral CT imaging for assessment of metastases in melanoma patients: multi-reader evaluation.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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17 authors.
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Abstract
backgroundPilot studies have indicated diagnostic benefits from using dual-energy CT (DECT) for staging and follow-up of melanoma patients. The purpose of this study was to investigate the sensitivity, specificity and qualitative assessment of spectral image reconstructions for metastases in melanoma patients in a large-scale, multi-reader evaluation.
methodsIn total, 308 patients with melanoma, 95 patients with metastases and a control group of 213 patients without metastases, who underwent oncologic staging CT of the chest, abdomen and pelvis on a dual-layer dual-energy CT system (dlDECT) were retrospectively included. Conventional images (CI), color-coded iodine overlays (IO) and virtual monoenergetic images at 40 keV (VMI
resultsSensitivity for detection of metastases in the skeletal muscle and peritoneum was significantly higher for the spectral assessment (for skeletal muscle 70% vs. 61%; for peritoneum 76% vs. 62%, both: p < 0.05). For subcutaneous metastases, there was a significant increase in specificity (92% vs. 89%, p < 0.05), however accompanied with a significant decrease in sensitivity (79% vs. 85%, p < 0.05). Diagnostic certainty was rated significantly higher for spectral images than CI in all (6/6) of the assessed tissues, whereas improvements in lesion delineation were noted for the skeletal muscle, the subcutaneous tissue and the pancreas.
conclusionsWe found that in melanoma patients, the benefit of dlDECT-derived spectral reconstructions depends on the assessed tissue. While assessment of skeletal muscle and peritoneal metastases was significantly improved, low or absent iodine uptake of subcutaneous lesions led to false negatives and a consecutive decrease in sensitivity.
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