FDG-PET/CT for staging of non-small cell lung cancer
2006
485 Objectives: Evaluation of the accuracy of CT alone, PET alone and integrated PET/CT for staging of patients with initial diagnosis of non-small cell lung cancer (NSCLC). Methods: In this prospective study, patients with clinical diagnosis of non-small cell lung cancer had imaging with integrated PET/CT before undergoing resective surgery. Approx. 60 min after i.v.-injection of 370 - 550 MBq F-18 FDG, contrast enhanced spiral CT was performed covering the neck, thorax, abdomen and pelvis followed by FDG-PET imaging using a GE Discovery LS hybrid scanner. CT, PET and integrated PET/CT were reviewed independently by two radiologists and two nuclear medicine physicians regarding T-stage and nodal stage. Readers were able to indicate a second result in case of equivocal findings. The histopathological result served as reference for T-stage and nodal stage. Results: A histopathological stage according to the TNM-classification system was available in 81 pts. with NSCLC. 9 pts. had a pulmonary carcinoid and further 22 pts. other malignant or benign tumors. The accuracy of CT alone for differentiation of T1/T2 tumors, T3 and T4 tumors was 68%, of PET alone 70% and of integrated PET/CT 82% (p Conclusions: For TNM-staging of non-small cell lung cancer, integrated PET/CT is significantly more accurate compared to CT alone and PET alone. The reliability of diagnostic findings could be significantly enhanced with integrated PET/CT.
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