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Onkologische Welt 2010; 01(05): 213-218
DOI: 10.1055/s-0038-1632897
Review
Schattauer GmbH

How to choose PET-CT or CT in the diagnosis and staging of lung cancer

Practical experience in ChinaWahl zwischen PET-CT oder CT in der LungenkrebsdiagnostikPraktische Erfahrungen aus China
T. Jiang   *
1   Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, Shanghai
,
X. Zheng   *
2   Department of Nutrition, ChangHai Hospital Affiliated to Second Military Medical University, Shanghai
,
X. Tao
1   Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, Shanghai
,
H. Liu
1   Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, Shanghai
,
S. Liu
1   Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, Shanghai
› Author Affiliations
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Publication History





Publication Date:
02 February 2018 (online)

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Summary

Purpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT. Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

Zusammenfassung

Der adäquate Einsatz von CT und PET-CT zur Verbesserung der Kosten-Nutzen-Relation bei Diagnose, Staging und Prognosebeurteilung von Lungenkrebs ist ein Thema, das von chinesischen Klinikern und Radiologen wohl überlegt sein sollte.

Wir prüfen die rationale Anwendung von CT und PET-CT bei Lungenkrebs unter vier Aspekten: Screening und Nachweis, morphologische Beurteilung, Untersuchung hämodynamischer oder metabolischer Eigenschaften sowie Nachuntersuchung, Staging und Prognosebeurtei-lung. Da PET-CT nur in Klasse-III-A-Kliniken zur Verfügung steht, gehört die CT in China zur gängigsten Ausstattung. PET-CT bietet mehr Vorteile, wenn ein Lungenkrebs im CT atypisch oder schwer zu beurteilen ist oder in Fällen, in denen die Diagnose Lungen krebs initial bestätigt wurde und das klinische Staging sowie eine therapeutische Entscheidungen benötigt werden. Wir geben auch Empfehlungen zum Einsatz von CT- und PET-CT bei solitären Lungenrundherden (SPN) in China.

Keywords

Lung cancer - computed tomography - positron emission tomography - diagnosis - China - imaging

Schlüsselwörter

Lungenkrebs - Computertomographie - Positronenemissionstomographie - Diagnose - China - bildgebende Verfahren

* These authors contributed equally to this work.


 

  • References

  • 1 Schoepf UJ, Becker CR, Obuchowski NA. et al. Multi-slice computed tomography as a screening tool for colon cancer, lung cancer and coronary artery disease. Eur Radiol 2001; 11: 1975-1985.
    CrossrefPubMedGoogle Scholar
  • 2 Zwirewich CV, Mayo JR, Müller NL. Low-dose high-resolution CT of lung parenchyma. Radiology 1991; 180: 413-417.
    CrossrefPubMedGoogle Scholar
  • 3 Bryant AS, Cerfolio RJ. The maximum standardized uptake values on integrated FDG-PET/CT is useful in differentiating benign from malignant lung cancer. Ann Thorac Surg 2006; 82: 1016-1020.
    CrossrefPubMedGoogle Scholar
  • 4 Kaneko M, Eguchi K, Ohmatsu H. et al. Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology 1996; 201: 798-802.
    CrossrefPubMedGoogle Scholar
  • 5 Henschke CI, McCauley DI, Yankelevitz DF. et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354: 99-105.
    CrossrefPubMedGoogle Scholar
  • 6 Diederich S, Lenzen H, Windmann R. et al. Lung cancer: experimental and clinical studies at low-dose CT. Radiology 1999; 213: 289-298.
    CrossrefPubMedGoogle Scholar
  • 7 Sone S, Li F, Yang ZG. et al. Characteristics of small lung cancers invisible on conventional chest radiography and detected by population based screening using spiral CT. Br J Radiol 2000; 73: 137-145.
    CrossrefPubMedGoogle Scholar
  • 8 Swensen SJ, Jett JR, Hartman TE. et al. CT screening for lung cancer: Five-year prospective experience. Radiology 2005; 235: 259-265.
    CrossrefPubMedGoogle Scholar
  • 9 Giunta S, Tipaldi L, Diotellevi F. et al. Performance of a cornputer-aided diagnosis(CAD)system for the detection of lung cancer at multidetector CT data in low dose lung cancer screening. Cli Imaging 2005; 29: 298-301.
    Google Scholar
  • 10 Lee JW, Goo JM, Lee HJ. et al. The potential contribution of a computer-aided detection system for lung nodule detection in multidetector row computed tomography. Invest Radiol 2004; 39: 649-655.
    CrossrefPubMedGoogle Scholar
  • 11 Swensen SJ, Brown LR, Colby TV. et al. Lung cancer: CT evaluation of enhancement with iodinated contrast material. Radiology 1995; 194: 393-398.
    CrossrefPubMedGoogle Scholar
  • 12 Swensen SJ, Brown LR, Colby TV. et al. Lung nodule enhancement at CT: prospective findings. Radiology 1996; 201: 447-455.
    CrossrefPubMedGoogle Scholar
  • 13 Swensen SJ, Viggiano RW, Midthun DE. et al. Lung nodule enhancement at CT: multicenter study. Radiology 2000; 214: 73-80.
    CrossrefPubMedGoogle Scholar
  • 14 Choi JB, Park CK, Park DW. et al. Does contrast enhancement on CT suggest tumor response for chemotherapy in small cell carcinoma of the lung?. J Comput Assist Tomogr 2002; 26: 797-800.
    CrossrefPubMedGoogle Scholar
  • 15 Yi CA, Lee KS, Kim EA. et al. Solitary lung cancer: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology 2004; 233: 191-199.
    CrossrefPubMedGoogle Scholar
  • 16 Jeong YJ, Lee KS, Jeong SY. et al. Solitary pulmonary nodule: characterization with combined wash-in and washout features at dynamic multi-detector row CT. Radiology 2005; 237: 675-683.
    CrossrefPubMedGoogle Scholar
  • 17 Bayraktaroglu S, Savas R, Basoglu OK. et al. Dynamic computed tomography in solitary lung cancer. J Comput Assist Tomogr 2008; 32: 222-227.
    CrossrefPubMedGoogle Scholar
  • 18 Zhang M, Kono M. Solitary lung cancer: evaluation of blood flow patterns with dynamic CT. Radiology 1997; 205: 471-478.
    CrossrefPubMedGoogle Scholar
  • 19 LI SJ, XIA0 XS LI HM. et al. Evaluation of blood flow pattern of solitary lung cancer with dynamic enhanced multi-slice spiral CT scanning. Journal of Clinical Radiology 2003; 22: 748-752.
    Google Scholar
  • 20 LI SJ, XIAO XS, LIU SY. et al. Blood flow patterns of solitary lung cancer with enhancementæºclinical value of multi-slice spiral CT. Chin J Radiol 2004; 38: 1062-1068.
    Google Scholar
  • 21 Ovali GY, Sakar A, Oktan C. Thorax perfusion CT in non-small cell lung cancer. Comput-Med-Imaging-Graph 2007; 31: 686-691.
    PubMedGoogle Scholar
  • 22 LI SJ, XIAO XS, LIU SY. et al. The clinical value of volume perfusion imaging with dynamic CT in the solitary lung cancer. Journal of Clinical Radiology 2008; 29: 1220-1224.
    Google Scholar
  • 23 LI SJ, XIAO XS, LIU SY. et al. Correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in maliagmant solitary lung cancer and tumor size. Chinese Journal of Lung Cancer 2008; 11: 74-78.
    PubMedGoogle Scholar
  • 24 Yi CA, Lee KS, Kim BT. et al. Tissue characterization of solitary pulmonary nodule: comparative study between helical dynamic CT and integrated PET/ CT. J Nucl Med 2006; 47: 443-450.
    PubMedGoogle Scholar
  • 25 Goo JM, Im JG, Do KH. et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 2000; 216: 117-121.
    CrossrefPubMedGoogle Scholar
  • 26 Erasmus JJ, McAdams HP, Patz Jr EF. et al. Evaluation of primary pulmonary carcinoid tumors using FDG PET. AJR Am J Roentgenol 1998; 170: 1369-1373.
    CrossrefPubMedGoogle Scholar
  • 27 Lee KS, Jeong YJ, Han J. et al. T1 non-small cell lung cancer: imaging and histopathologic findings and their prognostic implications. Radiographics 2004; 24: 1617-1636.
    CrossrefPubMedGoogle Scholar
  • 28 Dewan NA, Gupta NC, Redepenning LS. et al. Diagnostic efficacy of PET-FDG imaging in solitary lung cancer. Potential role in evaluation and management. Chest 1993; 104: 997-1002.
    CrossrefPubMedGoogle Scholar
  • 29 Gupta NC, Maloof J, Gunel E. Probability of malignancy in solitary lung cancer using fluorine-18-FDG and PET. J Nucl Med 1996; 37: 948-949.
    PubMedGoogle Scholar
  • 30 Lowe VJ, Fletcher JW, Gobar L. et al. Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol 1998; 16: 1075-1084.
    CrossrefPubMedGoogle Scholar
  • 31 Lee J, Aronchick JM, Alavi A. Accuracy of 18F fluoro -deoxyglucose positron emission tomography for the evaluation of malignancy in patients presenting with new lung abnormalities: a retrospective review. Chest 2001; 120: 1791-1797.
    CrossrefPubMedGoogle Scholar
  • 32 Herder GJ, Golding RP, Hoekstra OS. et al. The performance of 18F-fluorodeoxyglucose positron emission tomography in small solitary lung cancer. Eur J Nucl Med Mol Imaging 2004; 31: 1231-1236.
    PubMedGoogle Scholar
  • 33 Halley A, Hugentobler A, Icard P. et al. Efficiency of 18F-FDG and 99mTc-depreotide SPECT in the diagnosis of malignancy of solitary lung cancer. Eur J Nucl Med Mol Imaging 2005; 32: 1026-1032.
    CrossrefPubMedGoogle Scholar
  • 34 Kim SK, Allen-Auerbach M, Goldin J. et al. Accuracy of PET/CT in characterization of solitary pulmonary lesions. J Nucl Med 2007; 48: 214-220.
    PubMedGoogle Scholar
  • 35 Duan Y, Yu LJ, Lu PO. et al. Comparative study of 18F-FDG PETñ¯CT imaging and pathologic diagnosis in 53 non-small cell lung cancer. J Med Imaging 2007; 17: 1167-70.
    Google Scholar
  • 36 Li H, Xu WN, Zhang CX. The value of 18F-FDG PET/CT in differentiating malignant tumors from benign lesions in the lung. Chinese Journal of Clinical Oncology 2008; 35: 621-624.
    Google Scholar
  • 37 Garg K, Keith R, Byers T. et al. Randomized controlled trial with low-dose spiral CT for lung cancer screening:Feasibility study and preliminary results. Radiology 2002; 225: 505-510.
    Google Scholar
  • 38 Noguchi M, Morikawa M, Kawasaki M. et al. Small adenocarcinoma of the lung :Histologic characteristics and prognosis. Cancer 1995; 75: 2844-2852.
    CrossrefPubMedGoogle Scholar
  • 39 Konishi J, Yanmzaki K, Tsukamoto E. et al. Mediastinal lymph node staging by FDG-PET in patients with non-small cell lung cancer analysis of false-positive FDG-PET findings. Respiration 2003; 70: 500-506.
    CrossrefPubMedGoogle Scholar
  • 40 Takamochi K, Yoshida J, Murakami K. et al. Pitfalls in lymph node staging with positron emission tomography in non-small cell lung cancer patients. Lung Cancer 2005; 47: 235-242.
    CrossrefPubMedGoogle Scholar
  • 41 Graeter TP, Hellwig D, Hoffmann K. et al. Mediastinal lymph node staging in suspected lung cancer: comparison of positron emission tomography with 18F-fluorodeoxyglucose and mediastinoscopy. Ann Thorac Surg 2003; 75: 231-235.
    CrossrefPubMedGoogle Scholar
  • 42 Kim BT, Lee KS, Shim SS. et al. Stage T1 non-small cell lung cancer: preoperative mediastinal nodal staging with integrated FDG PET/CT – a prospective study. Radiology 2006; 241: 501-509.
    CrossrefPubMedGoogle Scholar
  • 43 Akhurst.. Lessons from the old masters: pragmatism or purity, FDG PET SUV, serum glucose and prediction of nodal status in non-small cell lung cancer. J Surg Oncol 2006; 94: 607-613.
    CrossrefPubMedGoogle Scholar