PET/CT in non-small-cell lung cancer: value of respiratory-gated PET.
The use of PET in the staging of patients with NSCLC is cost-effective, mainly due to a reduction in the number of futile operations. The addition of SUVmax to pathologic tumor size identifies a subgroup of patients at highest risk for death as a result of recurrent disease after resection. Tumor staging is more accurate with PET-CT than with CT alone or with PET alone. The greatest source of error in accurate localization and quantification on PET or PET-CT in lung cancer is respiratory motion. At MSKCC respiratory-gated PET (RGPET) is used in treatment planning. The lesion in the gated image is smaller in diameter than in the ungated image. Respiratory-correlated dynamic PET (RCDPET) can be considered an alternative method to RGPET. RCDPET shows very accurate local co-registration that can be used to make an attenuation correction and obtain an SUV. Gating gives a much clearer picture resulting in more than a one-third increase in the quantification. The SUV of lung lesions must be re-evaluated based on these techniques. This development will have important implications in areas such as the liver for controlling respiratory motion, which is a major problem in terms of lesion detection. We have successfully taken the first step in an attempt to correct for respiratory motion artifacts in PET imaging of lung lesions. (Chang
Larson
Steven M
SM
Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
Nehmeh
Sadek A
SA
Erdi
Yusuf E
YE
Humm
John L
JL
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18