Ultra-low-dose computed tomography and chest X-ray in follow-up of high-grade soft tissue sarcoma-a prospective comparative study.
Samuli SalminenSari JäämaaRiikka NevalaMarkus J SormaalaMika KoivikkoErkki TukiainenJussi RepoCarl BlomqvistMika M SampoPublished in: Scientific reports (2024)
Ultra-low-dose computed tomography (ULD-CT) may combine the high sensitivity of conventional computed tomography (CT) in detecting sarcoma pulmonary metastasis, with a radiation dose in the same magnitude as chest X-ray (CXR). Fifty patients with non-metastatic high-grade soft tissue sarcoma treated with curative intention were recruited. Their follow-up involved both CXR and ULD-CT to evaluate their different sensitivity. Suspected findings were confirmed by conventional CT if necessary. Patients with isolated pulmonary metastases were treated with surgery or stereotactic body radiation therapy (SBRT) with curative intent if possible. The median effective dose from a single ULD-CT study was 0.27 mSv (range 0.12 to 0.89 mSv). Nine patients were diagnosed with asymptomatic lung metastases during the follow-up. Only three of them were visible in CXR and all nine in ULD-CT. CXR had therefore only a 33% sensitivity compared to ULD-CT. Four patients were operated, and one had SBRT to all pulmonary lesions. Eight of them, however, died of the disease. Two patients developed symptomatic metastatic recurrence involving extrapulmonary sites+/-the lungs between two imaging rounds. ULD-CT has higher sensitivity for the detection of sarcoma pulmonary metastasis than CXR, with a radiation dose considerably lower than conventional CT.Clinical trial registration: NCT05813808. 04-14-2023.
Keyphrases
- low grade
- high grade
- dual energy
- computed tomography
- image quality
- contrast enhanced
- positron emission tomography
- low dose
- end stage renal disease
- radiation therapy
- newly diagnosed
- magnetic resonance imaging
- clinical trial
- high resolution
- pulmonary hypertension
- ejection fraction
- chronic kidney disease
- prognostic factors
- squamous cell carcinoma
- peritoneal dialysis
- randomized controlled trial
- rectal cancer
- acute coronary syndrome
- atrial fibrillation
- coronary artery disease
- free survival
- double blind
- radiation induced