Skip to main content

Advertisement

SpringerLink
Log in

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

  • Research Article
  • Published:
Molecular Imaging and Biology Aims and scope Submit manuscript

Abstract

Purpose

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.

Procedures

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.

Results

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.

Conclusion

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Coleman RE (1999) PET in lung cancer. J Nucl Med 40:814–820

    PubMed  CAS  Google Scholar 

  2. Dwamena BA, Sonnad SS, Angobaldo JO, Wahl RL (1999) Metastases from non-small cell lung cancer: mediastinal staging in the 1990s—meta-analytic comparison of PET and CT. Radiology 213:530–536

    PubMed  CAS  Google Scholar 

  3. Higashi K, Matsunari I, Ueda Y et al. (2003) Value of whole-body FDG PET in management of lung cancer. Ann Nucl Med 17:1–14

    Article  PubMed  Google Scholar 

  4. Hicks RJ, Kalff V, MacManus MP et al. (2001) The utility of (18)F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification. J Nucl Med 42:1605–1613

    PubMed  CAS  Google Scholar 

  5. Hellwig D, Groschel A, Graeter TP et al. (2006) Diagnostic performance and prognostic impact of FDG-PET in suspected recurrence of surgically treated non-small cell lung cancer. Eur J Nucl Med Mol Imaging 33:13–21

    Article  PubMed  Google Scholar 

  6. Townsend DW, Beyer T, Blodgett TM (2003) PET/CT scanners: a hardware approach to image fusion. Semin Nucl Med 33:193–204

    Article  PubMed  Google Scholar 

  7. Antoch G, Stattaus J, Nemat AT et al. (2003) Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 229:526–533

    Article  PubMed  Google Scholar 

  8. Lardinois D, Weder W, Hany TF et al. (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507

    Article  PubMed  Google Scholar 

  9. Shim SS, Lee KS, Kim BT et al. (2005) Non-small cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology 236:1011–1019

    Article  PubMed  Google Scholar 

  10. Kim BT, Lee KS, Shim SS et al. (2006) Stage T1 non-small cell lung cancer: preoperative mediastinal nodal staging with integrated FDG PET/CT—a prospective study. Radiology 241:501–509

    Article  PubMed  Google Scholar 

  11. Keidar Z, Haim N, Guralnik L et al. (2004) PET/CT using 18F-FDG in suspected lung cancer recurrence: diagnostic value and impact on patient management. J Nucl Med 45:1640–1646

    PubMed  Google Scholar 

  12. Slomka PJ, Dey D, Przetak C, Aladl UE, Baum RP (2003) Automated 3-dimensional registration of stand-alone (18)F-FDG whole-body PET with CT. J Nucl Med 44:1156–1167

    PubMed  Google Scholar 

  13. Nakamoto Y, Sakamoto S, Okada T et al. (2005) Accuracy of image fusion using a fixation device for whole-body cancer imaging. Am J Roentgenol 184:1960–1966

    Google Scholar 

  14. Toorongian SA, Mulholland GK, Jewett DM, Bachelor MA, Kilbourn MR (1990) Routine production of 2-deoxy-2-[18F]fluoro-D-glucose by direct nucleophilic exchange on a quaternary 4-aminopyridinium resin. Int J Radiat Appl Instrum B 17:273–279

    CAS  Google Scholar 

  15. Hudson HM, Larkin RS (1994) Accelerated image reconstruction using ordered subsets of projection data. IEEE Trans Med Imaging 13:601–609

    Article  PubMed  CAS  Google Scholar 

  16. Nakamoto Y, Sakamoto S, Okada T et al. (2007) Clinical value of manual fusion of PET and CT images in patients with suspected recurrent colorectal cancer. Am J Roentgenol 188:257–267

    Article  Google Scholar 

  17. Kim JH, Czernin J, Allen-Auerbach MS et al. (2005) Comparison between 18F-FDG PET, in-line PET/CT, and software fusion for restaging of recurrent colorectal cancer. J Nucl Med 46:587–595

    PubMed  Google Scholar 

  18. Cohade C, Osman M, Marshall LT, Wahl RL (2003) PET-CT: accuracy of PET and CT spatial registration of lung lesions. Eur J Nucl Med Mol Imaging 30:721–726

    Article  PubMed  Google Scholar 

  19. Lardinois D, Weder W, Roudas M et al. (2005) Etiology of solitary extrapulmonary positron emission tomography and computed tomography findings in patients with lung cancer. J Clin Oncol 23:6846–6853

    Article  PubMed  Google Scholar 

  20. Nie Y, Li Q, Li F, Pu Y, Appelbaum D, Doi K (2006) Integrating PET and CT information to improve diagnostic accuracy for lung nodules: a semiautomatic computer-aided method. J Nucl Med 47:1075–1080

    PubMed  Google Scholar 

  21. van Der Wel A, Nijsten S, Hochstenbag M et al. (2005) Increased therapeutic ratio by 18FDG-PET CT planning in patients with clinical CT stage N2-N3M0 non-small-cell lung cancer: a modeling study. Int J Radiat Oncol Biol Phys 61:649–655

    Google Scholar 

  22. Goerres GW, Burger C, Schwitter MR, Heidelberg TN, Seifert B, von Schulthess GK (2003) PET/CT of the abdomen: optimizing the patient breathing pattern. Eur Radiol 13:734–739

    Article  PubMed  Google Scholar 

  23. Gilman MD, Fischman AJ, Krishnasetty V, Halpern EF, Aquino SL (2006) Optimal CT breathing protocol for combined thoracic PET/CT. Am J Roentgenol 187:1357–1360

    Article  Google Scholar 

  24. Allen-Auerbach M, Yeom K, Park J, Phelps M, Czernin J (2006) Standard PET/CT of the chest during shallow breathing is inadequate for comprehensive staging of lung cancer. J Nucl Med 47:298–301

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Kyoto University Hospital, Kyoto, Japan

    Yuji Nakamoto, Tomohisa Okada, Tatsuya Higashi & Kaori Togashi

  2. Department of Image-based Medicine, Institute of Biomedical Research and Innovation, Kobe, Japan

    Yuji Nakamoto, Michio Senda, Tomohisa Okada & Setsu Sakamoto

  3. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan

    Setsu Sakamoto

  4. Department of Diagnostic Imaging Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan

    Tsuneo Saga

Authors
  1. Yuji Nakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michio Senda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomohisa Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Setsu Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tsuneo Saga
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tatsuya Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kaori Togashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuji Nakamoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakamoto, Y., Senda, M., Okada, T. et al. Software-based Fusion of PET and CT Images for Suspected Recurrent Lung Cancer. Mol Imaging Biol 10, 147–153 (2008). https://doi.org/10.1007/s11307-008-0131-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11307-008-0131-x

Key words

Search

Navigation