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Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT

Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland

View larger version (73K): [in this window] [in a new window]   FIGURE 1.  Pure bronchioloalveolar carcinoma, T1 N0 M0. (A) Tumor seen on CT and PET/CT lung window and on 18F-FDG PET images is shown (tumor size, 22 x 12 mm; HUmax, –138; SUVmax, 0.84). (B) Same tumor on mediastinal window was undetectable.

View larger version (63K): [in this window] [in a new window]   FIGURE 2.  Adenocarcinoma with BAC component, T1 N0 M0. (A) Tumor seen on CT and PET/CT lung window and on 18F-FDG PET images is shown (tumor size, 29 x 19 mm; HUmax, 65; SUVmax, 11.92). (B) Same tumor on mediastinal window was measured at 20 x 17 mm.

View larger version (12K): [in this window] [in a new window]   FIGURE 3.  (A) Mean visual score of BAC was significantly lower than that of Adeno+BAC (P < 0.0001). (B) Mean SUVmax of BAC was significantly lower than that of Adeno+BAC (P < 0.0001). (C) Scatter plot of SUVmax in individual lesions in BAC and Adeno+BAC.

View larger version (11K): [in this window] [in a new window]   FIGURE 4.  (A) Max D in mediastinal window of BAC was significantly lower than that of Adeno+BAC (P < 0.0001). (B) Max D in lung window of BAC was significantly lower than that of Adeno+BAC (P < 0.0001). (C) Mean TDR percentage of BAC was significantly higher than that of Adeno+BAC (P < 0.0001).

View larger version (6K): [in this window] [in a new window]   FIGURE 5.  (A) Mean HUmax of BAC was significantly lower than that of Adeno+BAC (P < 0.0001). (B) Scatter plot of HUmax in individual lesions in BAC and Adeno+BAC.

View larger version (8K): [in this window] [in a new window]   FIGURE 6.  (A) Positive correlation between tumor size on the mediastinal window and HUmax in BAC (P = 0.002, R2 = 0.57). (B) Positive correlation between tumor size on the mediastinal window and HUmax in Adeno+BAC (P = 0.0002, R2 = 0.61).