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PET-CT in clinical oncology

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Abstract

Anatomic imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have been used for many years in clinical oncology. The emergence of positron emission tomography (PET) more than a decade ago was a major breakthrough in the early diagnosis of malignant lesions, as it was based on tumour metabolism and not on anatomy. The merger of both techniques into one thanks to PETCT cameras has made this technology the most important tool in the management of cancer patients. PET/CT with 18F-FDG is increasingly being used for staging, restaging and treatment monitoring for cancer patients with different types of tumours (lung, breast, colorectal, lymphoma, melanoma, head and neck etc.). At many institutions, PET/CT has replaced separately acquired PET and CT examinations for many oncologic indications. This replacement has occurred despite the fact that only a relatively small number of well designed prospective studies have verified imaging findings against the gold standard of histopathologic tissue evaluation. However, a large number of studies have used acceptable reference standards, such as pathology, imaging and other clinical follow-up findings, for validating PET/CT findings. The impact on the management of patients and the benefits from the information obtained from this anatomo-metabolic procedure justify the term “clinical oncology based on PET-CT” as a new concept to be applied in clinical practice.

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References

  1. Townsend DW (2001) A combined PET/CT scanner: the choices. J Nucl Med 42:533–534

    PubMed  CAS  Google Scholar 

  2. Czernin J, Dahlbom M, Ratib O et al (2004) Introduction. In: Czernin J, Dahlbom M, Ratib O, Schiepers C (eds) Atlas of PET/CT imaging in oncology. Springer-Verlag, Berlin, Heidelberg

    Google Scholar 

  3. Rodríguez M, Asensio C, Maldonado A et al (2004) PET-TAC: Indicaciones, revisión sistemática y meta-análisis. Informe de la Agencia de Evaluación de Tecnologías Sanitarias No 41. Instituto de Salud Carlos III. Ministerio de Sanidad y Consumo. Madrid, June

  4. Andradas E, Reza M, Gómez N et al (2004) Efectividad, seguridad e indicaciones del sistema híbrido PET/TAC. Informe Técnico IT01/2004. Unidad de Evaluación de Tecnologías Sanitarias. Agencia Laín Entralgo. October

  5. Rodríguez M, Asensio C (2005) Uso Tutelado de la PET con FDG. Ministerio de Sanidad y Consumo. Instituto de Salud Carlos III. Agencia de Evaluación de Tecnologías Sanitarias (AETS). Madrid, November. ISBN: 84-95463-30-X

  6. Cohade C, Mourtzikos KA, Wahl RL (2003) “USA-Fat”: prevalence is related to ambient outdoor temperature — evaluation with 18F-FDG PET/CT. J Nucl Med 44:1267–1270

    PubMed  Google Scholar 

  7. Zimmer L, Snyderman CH, Fukui M et al (2005) The use of combined PET/CT for localizing recurrent head and neck cancer: the Pittsburgh experience. Ear Nose Throat J 84:108–110

    Google Scholar 

  8. Branstetter BF IV, Blodgett TM, Zimmer LA et al (2005) Head and neck malignancy: is PET/CT more accurate than PET or CT alone? Radiology 235:580–586

    Article  PubMed  Google Scholar 

  9. Schöder H, Yeung HWD, Gonen M et al (2004) Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion. Radiology 231:65–72

    Article  PubMed  Google Scholar 

  10. Gordin A, Daitzchman M, Doweck I et al (2006) Fluorodeoxyglucose-positron emission tomography/computed tomography imaging in patients with carcinoma of the larynx: diagnostic accuracy and impact on clinical management. Laryngoscope 116:273–278

    Article  PubMed  Google Scholar 

  11. Schoder H, Carlson DL, Kraus DH et al (2006) 18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med 47:755–762

    PubMed  Google Scholar 

  12. Chen Y, Su C, Ding H et al (2006) Clinical usefulness of fused PET/CT compared with PET alone or CT alone in nasopharyngeal carcinoma patients. Anticancer Res 26:1471–1477

    PubMed  Google Scholar 

  13. Nahas Z, Goldenberg D, Fakhry C et al (2005) The role of positron emission tomography/computed tomography in the management of recurrent papillary thyroid carcinoma. Laryngoscope 115:237–243

    Article  PubMed  Google Scholar 

  14. Palmedo H, Bucerius J, Joe A et al (2006) Integrated PET/CT in differentiated thyroid cancer: diagnostic accuracy and impact on patient management. J Nucl Med 47:616–624

    PubMed  Google Scholar 

  15. Gould MK, Maclean CC, Kuschner WG et al (2001) Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA 285:914–924

    Article  PubMed  CAS  Google Scholar 

  16. Petkovska I, Shah SK, McNitt-Gray MF et al (2006) Pulmonary nodule characterization: a comparison of conventional with quantitative and visual semi-quantitative analyses using contrast enhancement maps. Eur J Radiol 59:244–252

    Article  PubMed  Google Scholar 

  17. Yi CA, Lee KS, Kim B-T et al (2006) Tissue characterization of solitary pulmonary nodule: comparative study between helical dynamic CT and integrated PET/CT. J Nucl Med 47:443–450

    PubMed  Google Scholar 

  18. McKenna R, Libshitz H, Mountain C, McMurtey M (1985) Roentgenographic evaluation of mediastinal lymph nodes for pre-operative assessment in lung cancer. Chest 88:206–210

    PubMed  Google Scholar 

  19. Dwamena B, Sonnad S, Angobaldo J, Wahl R (1999) Metastases from non-small cell lung cancer: mediastinal staging in the 1990s — meta-analytic comparison of PET and CT. Radiology 213:530–536

    PubMed  CAS  Google Scholar 

  20. Lardinois D, Weder W, Hany T et al (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507

    Article  PubMed  Google Scholar 

  21. Antoch G, Stattaus J, Nemat A et al (2003) Nonsmall cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 229:526–533

    Article  PubMed  Google Scholar 

  22. Halpern BS, Schiepers C, Weber WA et al (2005) Presurgical staging of non-small cell lung cancer: positron emission tomography, integrated positron emission tomography/CT, and software image fusion. Chest 128:2289–2297

    Article  PubMed  Google Scholar 

  23. Shim SS, Lee KS, Kim B-T et al (2005) Nonsmall cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology 236:1011–1019

    Article  PubMed  Google Scholar 

  24. Keidar Z, Haim N, Guralnik L et al (2004) PET/CT using 18F-FDG in suspected lung cancer recurrence: diagnostic value and impact on patient management. J Nucl Med 45:1640–1646

    PubMed  Google Scholar 

  25. Lardinois D, Weder W, Roudas M et al (2005) Etiology of solitary extrapulmonary positron emission tomography and computed tomography findings in patients with lung cancer. J Clin Oncol 23:6846–6853

    Article  PubMed  Google Scholar 

  26. Hoekstra CJ, Stroobants SG, Smit EF et al (2005) Prognostic relevance of response evaluation using [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with locally advanced non-small-cell lung cancer. J Clin Oncol 23:8362–8370

    Article  PubMed  Google Scholar 

  27. De Leyn P, Stroobants S, De Wever W et al (2006) Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 non-small-cell lung cancer: a Leuven Lung Cancer Group study. J Clin Oncol 24: 3333–3339

    Article  PubMed  Google Scholar 

  28. Pottgen C, Levegrun S, Theegarten D et al (2006) Value of 18F-fluoro-2-deoxy-D-glucosepositron emission tomography/computed tomography in non-small-cell lung cancer for prediction of pathologic response and times to relapse after neoadjuvant chemoradiotherapy. Clin Cancer Res 12:97–106

    Article  PubMed  Google Scholar 

  29. Cerfolio RJ, Bryant AS, Ojha B (2006) Restaging patients with N2 (stage IIIa) nonsmall cell lung cancer after neoadjuvant chemoradiotherapy: a prospective study. J Thorac Cardiovasc Surg 131:1229–1235

    Article  PubMed  Google Scholar 

  30. Fueger B, Weber W, Quon A et al (2005) Performance of 2-deoxy-2-[F-18]fluoro-dglucose positron emission tomography and integrated PET/CT in restaged breast cancer patients. Mol Imaging Biol 7:369–376

    Article  PubMed  Google Scholar 

  31. Tatsumi M, Cohade C, Mourtzikos KA et al (2006) Initial experience with FDG-PET/CT in the evaluation of breast cancer. Eur J Nucl Med Mol Imaging 33:254–262

    Article  PubMed  Google Scholar 

  32. Bar-Shalom R, Guralnik L, Tsalic M et al (2005) The additional value of PET/CT over PET in FDG imaging of oesophageal cancer. Eur J Nucl Med Mol Imaging 32:918–924

    Article  PubMed  Google Scholar 

  33. Yuan S, Yu Y, Chao KSC et al (2006) Additional value of PET/CT over PET in assessment of locoregional lymph nodes in thoracic esophageal squamous cell cancer. J Nucl Med 47:1255–1259

    PubMed  Google Scholar 

  34. Jadvar H, Henderson RW, Conti PS (2006) 2-Deoxy-2-[F-18]fluoro-d-glucose positron emission tomography/computed tomography imaging evaluation of esophageal cancer. Mol Imaging Biol 8:193–200

    Article  PubMed  Google Scholar 

  35. Cohade C, Osman M, Leal J, Wahl R (2003) Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 44:1797–1803

    PubMed  Google Scholar 

  36. Kamel IR, Cohade C, Neyman E et al (2004) Incremental value of CT in PET/CT of patients with colorectal carcinoma. Abdom Imaging 29:663–668

    Article  PubMed  CAS  Google Scholar 

  37. Kim JH, Czernin J, Allen-Auerbach MS et al (2005) Comparison between 18F-FDG PET, inline PET/CT, and software fusion for restaging of recurrent colorectal cancer. J Nucl Med 46:587–595

    PubMed  Google Scholar 

  38. Votrubova J, Belohlavek O, Jaruskova M et al (2006) The role of FDG-PET/CT in the detection of recurrent colorectal cancer. Eur J Nucl Med Mol Imaging 33:779–784

    Article  PubMed  Google Scholar 

  39. Even-Sapir E, Parag Y, Lerman H et al (2004) Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection. Radiology 232:815–822

    Article  PubMed  Google Scholar 

  40. Selzner M, Hany TF, Wildbrett P et al (2004) Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver? Ann Surg 240: 1027–1034

    Article  PubMed  Google Scholar 

  41. Imdahl A, Nitzsche E, Krautmann F et al (1999) Evaluation of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose for the differentiation of chronic pancreatitis and pancreatic cancer. Br J Surg 86:194–199

    Article  PubMed  CAS  Google Scholar 

  42. Heinrich S, Goerres GW, Schafer M et al (2005) Positron emission tomography/ computed tomography influences on the management of resectable pancreatic cancer and its cost-effectiveness. Ann Surg 242:235–243

    Article  PubMed  Google Scholar 

  43. Petrowsky H, Wildbrett P, Husarik DB et al (2006) Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. J Hepatol 45:43–50

    Article  PubMed  Google Scholar 

  44. Stroobants S, Goeminne J, Seegers M et al (2003) 18FDG-positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 39:2012–2020

    Article  PubMed  CAS  Google Scholar 

  45. Goerres GW, Stupp R, Barghouth G et al (2005) The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: longterm outcome of treatment with imatinib mesylate. Eur J Nucl Med Mol Imaging 32:153–162

    Article  PubMed  CAS  Google Scholar 

  46. Antoch G, Kanja J, Bauer S et al (2004) Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med 45:357–365

    PubMed  CAS  Google Scholar 

  47. Allen-Auerbach M, Quon A, Weber WA et al (2004) Comparison between 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography and positron emission tomography/computed tomography hardware fusion for staging of patients with lymphoma. Mol Imaging Biol 6:411–416

    Article  PubMed  Google Scholar 

  48. Freudenberg LS, Antoch G, Schatt P et al (2004) FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 31:325–329

    Article  PubMed  CAS  Google Scholar 

  49. Schaefer NG, Hany TF, Taverna C et al (2004) Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging — do we need contrast-enhanced CT? Radiology 232:823–829

    Article  PubMed  Google Scholar 

  50. Tatsumi M, Cohade C, Nakamoto Y et al (2005) Direct comparison of FDG PET and CT findings in patients with lymphoma: initial experience. Radiology 237:1038–1045

    Article  PubMed  Google Scholar 

  51. Schaefer NG, Strobel K, Taverna C, Hany TF (2007) Bone involvement in patients with lymphoma: the role of FDG-PET/CT. Eur J Nucl Med Mol Imaging 34:60–67

    Article  PubMed  Google Scholar 

  52. Sironi S, Buda A, Picchio M et al (2005) Lymph node metastasis in patients with clinical earlystage cervical cancer: detection with integrated FDG PET/CT. Radiology 238:272–279

    Article  PubMed  Google Scholar 

  53. Hauth E, Antoch G, Stattaus J et al (2005) Evaluation of integrated whole-body PET/ CT in the detection of recurrent ovarian cancer. Eur J Radiol 56:263–268

    Article  PubMed  Google Scholar 

  54. Sironi S, Messa C, Mangili G et al (2004) Integrated FDG PET/CT in patients with persistent ovarian cancer: correlation with histologic findings. Radiology 233:433–440

    Article  PubMed  Google Scholar 

  55. Scher B, Seitz M, Reiser M et al (2005) 18F-FDG PET/CT for staging of penile cancer. J Nucl Med 46:1460–1465

    PubMed  Google Scholar 

  56. Reinhardt MJ, Joe AY, Jaeger U et al (2006) Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N-and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 24: 1178–1187

    Article  PubMed  Google Scholar 

  57. Gutzeit A, Antoch G, Kuhl H et al (2005) Unknown primary tumors: detection with dualmodality PET/CT — initial experience. Radiology 234:227–234

    Article  PubMed  Google Scholar 

  58. Nanni C, Rubello D, Castellucci P et al (2005) Role of FDG PET/CT imaging for the detection of an unknown primary tumor: preliminary results in 21 patients. Eur J Nucl Med Mol Imaging 32:589–592

    Article  PubMed  CAS  Google Scholar 

  59. Iagaru A, Chawla S, Menendez L, Conti P (2006) 18F-FDG PET and PET/CT for detection of pulmonary metastases from musculoskeletal sarcomas. Nucl Med Commun 27:795–802

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Centro PET Recoletas La Milagrosa, Madrid, Spain

    A. Maldonado & F. J. González-Alenda

  2. Centro PET Recoletas, Valladolid, Spain

    M. Alonso & J. M. Sierra

Authors
  1. A. Maldonado
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  2. F. J. González-Alenda
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  3. M. Alonso
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  4. J. M. Sierra
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Correspondence to A. Maldonado.

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Supported by an unrestricted educational grant from Roche Farma S.A.

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Maldonado, A., González-Alenda, F.J., Alonso, M. et al. PET-CT in clinical oncology. Clin Transl Oncol 9, 494–505 (2007). https://doi.org/10.1007/s12094-007-0093-5

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  • DOI: https://doi.org/10.1007/s12094-007-0093-5

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