PET Versus PET/CT Dual-Modality Imaging in Evaluation of Lung Cancer
Section snippets
FDG-PET/CT versus FDG-PET
Several studies have reported a higher sensitivity of FDG-PET/CT compared with FDG-PET alone.
For tumor staging, the sole use of conventional FDG-PET is limited based on the limited anatomical data. Thus, tumor size and a potential infiltration may be difficult to assess on PET alone. It has been shown in recent studies that in tumor staging of patients who have lung cancer, analysis of integrated FDG-PET/CT images is superior to that of FDG-PET or CT images alone when assessing the tumor stage
FDG-PET/CT versus FDG-PET and CT read side by side
In general, visual correlation of CT and FDG-PET improves interpretation of both datasets [24], [28]. For image coregistration, computer-assisted support appears helpful. However, in clinical practice, routine acceptance of retrospective image fusion may be limited by the complexity of retrospective coregistration algorithms and their limited accuracy for aligning areas of interest in independently acquired scans. Nonlinear registration techniques are required to account for complex patient
Optimized PET/CT protocol
Local misregistration between the CT and the PET in integrated PET/CT and the use of CT contrast media may bias the PET tracer distribution following CT-based attenuation correction [36]. Consequently, protocol requirements for PET/CT with diagnostic CT include alternative contrast application schemes to handle CT contrast agents appropriately. In addition, a special breathing protocol can avoid motion-induced artifacts in the area of the diaphragm. Using an optimized acquisition protocol
Summary
Software coregistration of FDG-PET and CT datasets as well as integrated FDG-PET/CT enable significantly more accurate assessment of NSCLC staging than either modality alone. Integrated FDG-PET/CT has been shown to be more accurate in NSCLC staging than FDG-PET and CT read side by side. However, the benefits of anatometabolic imaging using FDG-PET/CT can only be fully exploited if optimized acquisition protocols are implemented.
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Cited by (29)
PET/MRI and PET/CT in lung lesions and thoracic malignancies
2015, Seminars in Nuclear MedicineCitation Excerpt :Whether the combination of both techniques with integrated PET/MRI scanners might bring further advantages in patient care is not yet answered. Recently published work focusing on whole-body MRI found the potential for comprehensive MR examinations of the lung and whole body to be comparable with integrated PET/CT for certain tumor entities.34 Preliminary data from Huellner et al30 recommend the use of respiratory-gated periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequences in whole-body PET/MRI with better results than that with whole-body PET/CT for staging and restaging of patients with cancer.
Current imaging in lung cancer
2013, Revista Medica Clinica Las CondesPostoperative FDG-PET/CT staging in GIST: Is there a benefit following R0 resection?
2011, European Journal of RadiologyCombined Contrast-Enhanced Computed Tomography and 18-Fluoro-2-Deoxy-d-Glucose-Positron Emission Tomography in the Diagnosis and Staging of Non-small Cell Lung Cancer
2011, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :Many centers throughout the country have FDG-PET scans read separately from the CT portion of the examination, the former by a nuclear medicine physician, and the latter by a radiologist. Simultaneous interpretation of PET/CT either by the use of coregistration of separate FDG-PET and CT datasets as well as integrated FDG-PET/CT has significantly superior accuracy to PET alone or CT alone or read side by side.31 PET/CT has superior accuracy in detection of pathologic lymph nodes as well as metastatic disease in patients with lung cancer.
<sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography-based radiotherapy target volume definition in non-small-cell lung cancer: Delineation by radiation oncologists vs. joint outlining with a PET radiologist?
2010, International Journal of Radiation Oncology Biology PhysicsReproducibility of "Intelligent" Contouring of Gross Tumor Volume in Non-Small-Cell Lung Cancer on PET/CT Images Using a Standardized Visual Method
2010, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :Positron emission tomography (PET) using the radiopharmaceutical 18F-fluorodeoxyglucose (FDG) is significantly more accurate than computed tomography (CT) alone in the diagnosis (1), staging (2, 3), and restaging (4) of lung cancer. PET/CT provides the most complete and reliable indication of the extent of gross tumor in non–small-cell lung cancer (NSCLC) available from any imaging investigation (5), and the use of FDG-PET/CT for radiation therapy (RT) planning is a dynamic area of research (6). The use of CT alone for tumor contouring is associated with extremely poor reproducibility (7), but when PET information is added, there is much greater congruence between observers (8, 9).
This article was previously published in PET Clinics 2006;1:347–52.