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A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure

View Article: PubMed Central - PubMed

ABSTRACT

Background: Because of the increasing importance of computer-assisted post processing of image data in modern medical diagnostic we studied the value of an algorithm for assessment of single photon emission computed tomography/computed tomography (SPECT/CT)-data, which has been used for the first time for lymph node staging in penile cancer with non-palpable inguinal lymph nodes. In the guidelines of the relevant international expert societies, sentinel lymph node-biopsy (SLNB) is recommended as a diagnostic method of choice. The aim of this study is to evaluate the value of the afore-mentioned algorithm and in the clinical context the reliability and the associated morbidity of this procedure.

Methods: Between 2008 and 2015, 25 patients with invasive penile cancer and inconspicuous inguinal lymph node status underwent SLNB after application of the radiotracer Tc-99m labelled nanocolloid. We recorded in a prospective approach the reliability and the complication rate of the procedure. In addition, we evaluated the results of an algorithm for SPECT/CT-data assessment of these patients.

Results: SLNB was carried out in 44 groins of 25 patients. In three patients, inguinal lymph node metastases were detected via SLNB. In one patient, bilateral lymph node recurrence of the groins occurred after negative SLNB. There was a false-negative rate of 4 % in relation to the number of patients (1/25), resp. 4.5 % in relation to the number of groins (2/44). Morbidity was 4 % in relation to the number of patients (1/25), resp. 2.3 % in relation to the number of groins (1/44). The results of computer-assisted assessment of SPECT/CT data for sentinel lymph node (SLN)-diagnostics demonstrated high sensitivity of 88.8 % and specificity of 86.7 %.

Conclusions: SLNB is a very reliable method, associated with low morbidity. Computer-assisted assessment of SPECT/CT data of the SLN-diagnostics shows high sensitivity and specificity. While it cannot replace the assessment by medical experts, it can still provide substantial supplement and assistance.

No MeSH data available.


Related in: MedlinePlus

Excerpt from the screen display of the software (InterView FUSION/Mediso) with axial CT scan of the abdomen. The hot spot marked with a cross on the right inguinal region was identified as a “true” finding by the software and thus as a true SLN. On the lower left periphery of the image you can find the lists of the “true” and “false” findings (red frame)
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Fig5: Excerpt from the screen display of the software (InterView FUSION/Mediso) with axial CT scan of the abdomen. The hot spot marked with a cross on the right inguinal region was identified as a “true” finding by the software and thus as a true SLN. On the lower left periphery of the image you can find the lists of the “true” and “false” findings (red frame)

Mentions: We determined parameters for each hot spot of the computer-assisted analysis for both imaging modalities and classified these as “true” or “false” findings based on the algorithm. For classification as a “true” finding and thus “true” lymph node the finding (hot spot) had to fulfill all criteria regarding predefined SPECT and CT parameters. The program finally offered the medical experts separate lists with “true” and “false” findings for perusal and checking. The order of both lists was determined by the program based on probability of the results being “true” or “false”. The individual probabilities were calculated based both on SPECT and CT [23]. These computer-generated lists are presented in Fig. 5 as a segment from the program’s user surface as shown the lower left screen. These lists with the “true” and “false” findings are then separately evaluated and corrected by the afore-mentioned experts and, in case that certain findings are considered falsely “true” or “false” by the individual expert, they are moved to the respective other list.Fig. 5


A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure
Excerpt from the screen display of the software (InterView FUSION/Mediso) with axial CT scan of the abdomen. The hot spot marked with a cross on the right inguinal region was identified as a “true” finding by the software and thus as a true SLN. On the lower left periphery of the image you can find the lists of the “true” and “false” findings (red frame)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5015237&req=5

Fig5: Excerpt from the screen display of the software (InterView FUSION/Mediso) with axial CT scan of the abdomen. The hot spot marked with a cross on the right inguinal region was identified as a “true” finding by the software and thus as a true SLN. On the lower left periphery of the image you can find the lists of the “true” and “false” findings (red frame)
Mentions: We determined parameters for each hot spot of the computer-assisted analysis for both imaging modalities and classified these as “true” or “false” findings based on the algorithm. For classification as a “true” finding and thus “true” lymph node the finding (hot spot) had to fulfill all criteria regarding predefined SPECT and CT parameters. The program finally offered the medical experts separate lists with “true” and “false” findings for perusal and checking. The order of both lists was determined by the program based on probability of the results being “true” or “false”. The individual probabilities were calculated based both on SPECT and CT [23]. These computer-generated lists are presented in Fig. 5 as a segment from the program’s user surface as shown the lower left screen. These lists with the “true” and “false” findings are then separately evaluated and corrected by the afore-mentioned experts and, in case that certain findings are considered falsely “true” or “false” by the individual expert, they are moved to the respective other list.Fig. 5

View Article: PubMed Central - PubMed

ABSTRACT

Background: Because of the increasing importance of computer-assisted post processing of image data in modern medical diagnostic we studied the value of an algorithm for assessment of single photon emission computed tomography/computed tomography (SPECT/CT)-data, which has been used for the first time for lymph node staging in penile cancer with non-palpable inguinal lymph nodes. In the guidelines of the relevant international expert societies, sentinel lymph node-biopsy (SLNB) is recommended as a diagnostic method of choice. The aim of this study is to evaluate the value of the afore-mentioned algorithm and in the clinical context the reliability and the associated morbidity of this procedure.

Methods: Between 2008 and 2015, 25 patients with invasive penile cancer and inconspicuous inguinal lymph node status underwent SLNB after application of the radiotracer Tc-99m labelled nanocolloid. We recorded in a prospective approach the reliability and the complication rate of the procedure. In addition, we evaluated the results of an algorithm for SPECT/CT-data assessment of these patients.

Results: SLNB was carried out in 44 groins of 25 patients. In three patients, inguinal lymph node metastases were detected via SLNB. In one patient, bilateral lymph node recurrence of the groins occurred after negative SLNB. There was a false-negative rate of 4 % in relation to the number of patients (1/25), resp. 4.5 % in relation to the number of groins (2/44). Morbidity was 4 % in relation to the number of patients (1/25), resp. 2.3 % in relation to the number of groins (1/44). The results of computer-assisted assessment of SPECT/CT data for sentinel lymph node (SLN)-diagnostics demonstrated high sensitivity of 88.8 % and specificity of 86.7 %.

Conclusions: SLNB is a very reliable method, associated with low morbidity. Computer-assisted assessment of SPECT/CT data of the SLN-diagnostics shows high sensitivity and specificity. While it cannot replace the assessment by medical experts, it can still provide substantial supplement and assistance.

No MeSH data available.


Related in: MedlinePlus