Lymph node staging with dual-modality PET/CT: enhancing the diagnostic accuracy in oncology.
Lymph node staging according to the TNM criteria is an essential part of tumor evaluation. Several morphological and functional imaging procedures are used complementarily in this setting. Dual-modality PET/CT scanners are able to provide anatomical and functional data sets in a single session with accurate image co-registration. Comparative studies between morphological imaging procedures, such as MRI and CT, with co-registered PET/CT demonstrated significantly better lymph node staging with PET/CT than with anatomical procedures alone, regardless of the staged body compartment (head and neck, thorax or abdominal area). Based on more accurate staging results, PET/CT was able to alter the patients' therapy in a significant number of studies. Functional imaging with FDG-PET ([(18)F]-2-fluoro-2-desoxy-D-glucose-positron emission tomography) demonstrated outstanding results in lymph node staging of different tumor diseases. By adding anatomical information to PET, PET/CT outperforms PET alone when assessing the TNM-stage of different malignant diseases. This paper provides an overview concerning the performance of PET/CT in staging lymph nodes for malignant spread and points out benefits and limitations of this new imaging modality.
Veit
Patrick
P
Department of Diagnostic and Interventional Radiology, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, Germany. patrick.veit@uni-essen.de
Ruehm
Stefan
S
Kuehl
Hilmar
H
Stergar
Hrvoje
H
Mueller
Stefan
S
Bockisch
Andreas
A
Antoch
Gerald
G
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008495:Medical Oncology / Q000592:standards*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18