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Annals of Nuclear Medicine

, Volume 22, Issue 7, pp 595–602 | Cite as

Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors

  • Kazuhiro Kitajima
  • Yuji Nakamoto
  • Hiromi Okizuka
  • Yumiko Onishi
  • Michio Senda
  • Narufumi Suganuma
  • Kazuro Sugimura
Original Article

Abstract

Objective

Positron emission tomography (PET) using 18F-fluoro-2-deoxy-d-glucose (FDG) has a limitation in detecting cerebral metastases; however, the feasibility of detection by inline PET/computed tomography (CT) system remains unknown. We evaluated the accuracy of FDG-PET/CT of body imaging protocol for the detection of cerebral metastases when compared with PET alone and CT alone.

Methods

Fifty patients underwent whole-body FDG-PET/CT scanning including the brain and contrastenhanced brain MR (magnetic resonance) scan. PET-only, CT-only, and the fused images were interpreted, and the confidence of presence of cerebral metastases was recorded using a five-point grading scale. Area under the receiver-operating characteristic (ROC) curve (Az) was calculated. Differences among the three modalities were tested with the Cochran-Q test, followed by multiple comparisons using the McNemar test with Bonferroni adjustment.

Results

Magnetic resonance imaging revealed 70 cerebral metastatic lesions in 20 patients. Patient-based analysis showed that the sensitivity, specificity, accuracy, and Az of PET-alone interpretation were 45%, 80%, 66%, and 0.6025, respectively, those of CT-alone interpretation were 50%, 97%, 78%, and 0.7158, respectively, and those of fused-image interpretation were 50%, 93%, 76%, and 0.7242, respectively. ROC analysis revealed significant differences among the three interpretation methods (P = 0.0238) and between PET and PET/CT (P = 0.0129). The sensitivity of PET, CT, and fused-image interpretation for detecting 70 lesions was 13%, 20%, and 20%, respectively.

Conclusions

Even with an integrated PET/CT scanner of body imaging protocol, the sensitivity of cerebral metastases remained unsatisfactory. To assess intracranial lesions, MR scanning should still be considered.

Keywords

Brain Metastasis FDG PET CT 

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Copyright information

© The Japanese Society of Nuclear Medicine 2008

Authors and Affiliations

  • Kazuhiro Kitajima
    • 1
    • 2
    • 3
  • Yuji Nakamoto
    • 5
  • Hiromi Okizuka
    • 3
  • Yumiko Onishi
    • 3
  • Michio Senda
    • 4
  • Narufumi Suganuma
    • 6
  • Kazuro Sugimura
    • 2
  1. 1.Department of RadiologyDokkyo University School of MedicineTochigiJapan
  2. 2.Department of RadiologyKobe University Graduate School of MedicineKobeJapan
  3. 3.Clinical PET CenterInstitute of Biomedical Research and InnovationKobeJapan
  4. 4.Division of Molecular ImagingInstitute of Biomedical Research and InnovationKobeJapan
  5. 5.Department of RadiologyKyoto University Graduate school of MedicineKyotoJapan
  6. 6.Department of Environmental MedicineKochi University Medical SchoolKochiJapan

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