Molecular Imaging and Biology

, Volume 10, Issue 3, pp 147–153

Software-based Fusion of PET and CT Images for Suspected Recurrent Lung Cancer

  • Yuji Nakamoto
  • Michio Senda
  • Tomohisa Okada
  • Setsu Sakamoto
  • Tsuneo Saga
  • Tatsuya Higashi
  • Kaori Togashi
Research Article



The purpose of this study was to compare the diagnostic performance of the manual fusion of positron emission tomography (PET) and computed tomography (CT) images with that of CT alone and that of side-by-side PET and CT (PET/CT) in patients with suspected recurrent lung cancer.


Fifty-three patients who had previously had surgery for lung cancer underwent a whole-body 2-deoxy-2-[F-18]fluoro-d-glucose (FDG)-PET scan, followed by a diagnostic CT scan. The PET and CT images were fused on a workstation. CT alone, PET/CT, and fused images were evaluated separately using a five-point grading scale (0 = definitely negative, 1 = probably negative, 2 = equivocal, 3 = probably positive, and 4 = definitely positive). Lesions of grade 3 or 4 were considered positive, and diagnostic accuracy and certainty were evaluated.


Overall, 67 lesions in 33 patients were considered true positive pathologically or clinically. Of these 67 lesions, the evaluation of CT, PET/CT, and fused images detected 46, 55, and 66 lesions, respectively, with the number of grade 4 lesions detected being 38, 50, and 63, respectively. The diagnostic accuracy of CT, PET/CT, and fused images according to patients was 75%, 79%, and 87%, respectively.


These results suggest that interpreting fused images increased diagnostic certainty for detecting recurrence and provided more accurate diagnoses.

Key words

FDG PET CT Lung cancer Recurrence 


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Copyright information

© Academy of Molecular Imaging 2008

Authors and Affiliations

  • Yuji Nakamoto
    • 1
    • 2
  • Michio Senda
    • 2
  • Tomohisa Okada
    • 1
    • 2
  • Setsu Sakamoto
    • 2
    • 3
  • Tsuneo Saga
    • 4
  • Tatsuya Higashi
    • 1
  • Kaori Togashi
    • 1
  1. 1.Department of Diagnostic RadiologyKyoto University HospitalKyotoJapan
  2. 2.Department of Image-based MedicineInstitute of Biomedical Research and InnovationKobeJapan
  3. 3.Department of RadiologyKobe University Graduate School of MedicineKobeJapan
  4. 4.Department of Diagnostic Imaging Molecular Imaging CenterNational Institute of Radiological SciencesChibaJapan

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