Picture this: New CT technique could safely monitor mesothelioma

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 - CT_Mesothelioma
Typical pleural plaques (1; white arrows), diffuse pleural thickening (2; white arrows) and parenchymal band (2; black arrows), and pulmonary nodule (3; white arrows) in axial plane and an example of normal images in axial plane (4). All Veo and filtered back projection (FBP) images are captured at the same anatomic level, with 100 kV and 20 mAs/section for Veo and 120 kV, 60 mAs for FBP.
Source: BMJ Open (10.1136/bmjopen-2014-004980)

A new CT technique that uses the Veo algorithm and filtered back projection (FBP) could screen for cancers like mesothelioma using less radiation by creating detailed pictures from CT scans, according to a study published online May 30 by BMJ Open.

“Although we know that asbestos work dramatically raises mesothelioma risk, there is still no safe way to effectively monitor expressed workers,” says Surviving Mesothelioma’s Managing Editor Alex Strauss in a press release. “If this new technology is proven to make CT scanning safer, it could be life saving for many people.”

Lead author Marielle Tekath, of the University Hospital CHU G. Montpied in Clermont-Ferrand, France, and colleagues compared two CT image-creation techniques in 27 asbestos-exposed workers. Two acquisitions were performed on a 64-slice CT during the study: the gold standard FBP followed by Veo reconstruction. Two radiologists independently assessed asbestos-related abnormalities, pulmonary nodules, radiation doses and image quality.

The radiologists observed 297 pleural plaques in 20 participants. All patients had pulmonary nodules, with a total of 167. The detection rates did not differ for pleural plaques as Veo had a rate of 87 percent and FBP had a rate of 97 percent. The detection rates for pleural thickening and pulmonary nodules were 100 percent for both techniques.

Interstitial abnormalities were depicted less frequently with Veo than FBP. In comparison with FBP, however, Veo decreased radiation dose up to 87 percent. The objective image noise also decreased with Veo up to 23 percent and signal-to-noise ratio increased up to 33 percent.

Veo acquisition was responsible for three false positives that corresponded to intercostal fat or muscles and eight false negatives. Because of these findings, the authors suggest that Veo reconstruction cannot be used for the first examination but could be used for patients’ follow-up.

Although images created with Veo had an unusual appearance, the image quality was generally accurate in its diagnosis and the reconstruction substantially reduces radiation, wrote the authors. “However, these results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions, especially regarding the low prevalence of interstitial abnormalities in this study,” they concluded.