Clinical Value of Combined Positron Emission Tomography/Computed Tomography Imaging in the Interpretation of 2-Deoxy-2-[F-18]fluoro-d-glucose–Positron Emission Tomography Studies in Cancer Patients
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Positron emission tomography (PET)/computed tomography (CT) is a new imaging modality that provides exact coregistration of anatomic and metabolic data. We have investigated to what degree this new technique might affect the interpretation of PET images in a nonselected group of consecutive cancer patients, reflecting routine condition in a busy cancer center.
Whole-body 2-deoxy-2-[F-18]fluoro-d-glucose (FDG)–PET and PET/CT fusion image sets were compared in 100 consecutive, nonselected patients: 21 with head and neck cancer, 39 with chest malignancies, and 40 with malignancies of the abdomen and pelvis. All studies were performed for primary staging or evaluation of therapy and were interpreted by two nuclear medicine physicians also trained in radiology. Areas of abnormal FDG uptake were identified on PET and graded as likely benign, equivocal, or likely malignant. Positron emission tomography/computed tomography fusion images were then made available, and the initial findings were amended if necessary.
One hundred sixty-six areas with abnormal FDG uptake were identified. Based on PET alone, 51 sites were considered equivocal for malignancy. With PET/CT, the number of equivocal lesions decreased to 24. This difference is more marked in the head and neck as well as the abdomen and pelvis. When the equivocal sites were included in the analysis and grouped with the malignant sites, positive predictive value (PPV) of PET/CT was 89% compared with 75% for PET (p = 0.04).
Combined PET/CT results in increased reader confidence and 53% fewer equivocal readings, as well as improved PPV compared with PET alone.
- Hustinx, R, Benard, F, Alavi, A (2002) Whole-body FDG-PET imaging in the management of patients with cancer. Semin Nucl Med 32: pp. 35-46
- Bomanji, JB, Costa, DC, Ell, PJ (2001) Clinical role of positron emission tomography in oncology. Lancet Oncol 2: pp. 157-164 CrossRef
- Bombardieri, E, Carrio, I, Gonzalez, P (1999) Current applications and perspectives of diagnostic nuclear medicine in oncology. Task Group of Oncology. Int J Oncol 14: pp. 877-890
- Bettinardi, V, Pagani, E, Gilardi, MC (1999) An automatic classification technique for attenuation correction in positron emission tomography. Eur J Nucl Med 26: pp. 447-458 CrossRef
- Beyer, T, Townsend, DW, Brun, T (2000) A combined PET/CT scanner for clinical oncology. J Nucl Med 41: pp. 1369-1379
- Trojan, A, Jermann, M, Taverna, C, Hany, TF (2002) Fusion PET-CT imaging of neurolymphomatosis. Ann Oncol 13: pp. 802-805 CrossRef
- Makhija, S, Howden, N, Edwards, R, Kelley, J, Townsend, DW, Meltzer, CC (2002) Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: A retrospective review. Gynecol Oncol 85: pp. 53-58 CrossRef
- Kluetz, P, Meltzer, C, Villemagne, V (2000) Combined PET/CT imaging in oncology. Impact on patient management. Clin Positron Imaging 3: pp. 223-230 CrossRef
- Hany, T, Steinert, H, Goerres, G, Buck, A, Schulthess, G (2002) PET diagnostic accuracy: Improvement with in-line PET-CT system: Initial results. Radiology 225: pp. 575-581
- Lardinois, D, Weder, W, Hany, TF (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348: pp. 2500-2507
- Gonen, M, Panageas, KS, Larson, SM (2001) Statistical issues in analysis of diagnostic imaging experiments with multiple observations per patient. Radiology 221: pp. 763-767
- Cohade, C, Osman, M, Nakamoto, Y (2003) Initial experience with oral contrast in PET/CT: Phantom and clinical studies. J Nucl Med 44: pp. 412-416
- Goerres, GW, Kamel, E, Seifert, B (2002) Accuracy of image coregistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med 43: pp. 1469-1475
- Clinical Value of Combined Positron Emission Tomography/Computed Tomography Imaging in the Interpretation of 2-Deoxy-2-[F-18]fluoro-d-glucose–Positron Emission Tomography Studies in Cancer Patients
Molecular Imaging and Biology
Volume 7, Issue 3 , pp 229-235
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- FDG PET scan in oncology
- Industry Sectors
- Author Affiliations
- 1. Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 2. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA