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Comparison of [¹⁸F]FDG PET and ²⁰¹Tl SPECT in Evaluation of Pulmonary Nodules

Departments of Radiology, Pathology, and Thoracic Surgery, Kanazawa Medical University, Kanazawa; and Department of Radiology, Kanazawa Cardiovascular Hospital, Kanazawa, Japan

View larger version (88K): [in a new window]   FIGURE 1. Patient 6 with bronchioloalveolar adenocarcinoma (2.0 x 2.0 cm), pT1N0M0. (A) CT image shows nodule in right lung. (B) FDG PET image does not reveal any lesions. (C) Early scan on 201Tl SPECT. (D) Delayed scan on 201Tl SPECT. 201Tl SPECT reveals good visualization of tumor (ER, 1.39; DR, 1.79; RI, 28.8%).

View larger version (65K): [in a new window]   FIGURE 2. Patient 28 with moderately differentiated adenocarcinoma (1.8 x 1.2 cm), pT1N0M0. (A) CT image shows nodule in right lung. (B) FDG PET image shows hot accumulation in tumor (SUV, 3.81; T/N, 5.14). (C) Early scan on 201Tl SPECT. (D) Delayed scan on 201Tl SPECT. Neither early nor delayed 201Tl SPECT revealed any lesions.

View larger version (80K): [in a new window]   FIGURE 3. Patient 66 with sarcoidosis (3.1 x 2.7 cm). (A) CT image shows nodule in right lung. (B) FDG PET image shows hot accumulation in nodule (SUV, 10.3; T/N, 15.3). (C) Early scan on 201Tl SPECT. (D) Delayed scan on 201Tl SPECT. 201Tl SPECT reveals good visualization of nodule (ER, 1.63; DR, 2.33; RI, 42.9%).

View larger version (22K): [in a new window]   FIGURE 4. Correlation was seen between FDG T/N and degree of cell differentiation in adenocarcinoma of lung. However, in 201Tl ER and DR, no significant difference was found between bronchioloalveolar carcinomas and poorly differentiated adenocarcinomas. In lung adenocarcinoma, FDG uptake, but not 201Tl uptake, reflects degree of cell differentiation. BAC = bronchioloalveolar carcinoma; Well = well-differentiated adenocarcinoma; Mod. = moderately differentiated adenocarcinoma; Poorly = poorly differentiated adenocarcinoma.