title: Coincidence detection FDG PET in the management of oncological patients: attenuation correction versus non-attenuation correction.
abstract: The aim of this study was to determine if attenuation correction (AC) in a dual-head, coincidence, positron emission tomography imaging system (Co-PET) improved image quality, lesion detection, patient staging and management of various malignant neoplasms, compared to non-attenuation corrected (NAC) images. Thirty patients with known or suspected malignant neoplasms underwent fluorodeoxyglucose (FDG) Co-PET, which was correlated with histopathology, computed tomography (CT) and other conventional imaging modalities and clinical follow-up. The number and location of FDG avid lesions detected on the AC images and NAC Co-PET images were blindly assessed by two independent observers. Semi-quantitative grading of image clarity and lesion-to-background quality was performed. This revealed markedly improved image clarity and lesion-to-background quality in the AC versus NAC Co-PET images. AC Co-PET was statistically superior to NAC Co-PET in relation to lesion detection (P<0.01) and tumour staging (P<0.01). NAC Co-PET demonstrated 51 of the 65 lesions (78%) detected by AC Co-PET. AC Co-PET altered tumour staging in five additional patients (16%) compared to NAC Co-PET. Management was altered in two of these five patients.
authors.affiliation: Department of Nuclear Medicine, St Vincent's Hospital, New South Wales, Australia. wlchan@iprimus.com.au
authors.forename: W L
authors.initials: WL
authors.lastname: Chan
authors.forename: J
authors.initials: J
authors.lastname: Freund
authors.forename: N A
authors.initials: NA
authors.lastname: Pocock
authors.forename: E
authors.initials: E
authors.lastname: Szeto
authors.forename: F
authors.initials: F
authors.lastname: Chan
authors.forename: B J
authors.initials: BJ
authors.lastname: Sorensen
authors.forename: B
authors.initials: B
authors.lastname: McBride
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D014055:Tomography, Emission-Computed / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18