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

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.

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