Performance of FDG PET/ceCT in the evaluation of patients with lung cancer.
OBJECTIVE
The aim of this study was to assess the performance of FDG PET/ceCT simultaneously acquired, contemporary read and finally discussed by the radiologist and the nuclear medicine physician for staging and restaging lung cancer patients.


METHODS
We analysed 17 consecutive patients (7F; 10M; mean age 68). Six patients were in staging, 8 patients were in restaging (1 during therapy, 2 after therapy and 5 during the follow-up) and 2 patients needed to characterise a suspect pulmonary mass. All the patients underwent combined FDG PET/CT and ceCT acquired simultaneously on the same tomograph. The images were read and reported together by the nuclear medicine physician and the radiologist.


RESULTS
None of the patients had adverse reactions nor complained about the procedure. Thirteen FDG PET/ceCT turned out positive, while 4 were completely negative. Among positive patients, a significant SUV max was detected in all the cases (range 1.8-17.5). In the end, 9 patients had a true positive result, 4 true negative, 3 false positive and 1 false negative. Sensitivity, specificity and accuracy of the combined procedure were 90%, 57% and 76% respectively. In 7/17 patients FDG PET/CT and ceCT were completely concordant. FDG PET/CT provided a significant impact on the final interpretation in 7/17 patients while ceCT had a major impact in 3/17 patients.


CONCLUSIONS
This preliminary study shows that FDG PET/ceCT is a feasible technique for lung cancer patients, providing an optimal sensitivity (90%). From our results it is advisable not to include patients without an histological diagnosis of cancer due to possible false positivity of the two methods, significantly reducing specificity. However, a proper patient selection is not easy and the future of this combined test relies essentially on the capacity to early identify only the subjects who would really benefit from both the procedures.
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Cristina
C
Nanni
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Virginia
V
Rossetti
Department of Radiology, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Maurizio
M
Zompatori
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Valentina
V
Ambrosini
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Valeria
V
Montesi
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Donatella
D
Mascherini
Service of Medical Physics, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Cinzia
C
Pettinato
Department of Nuclear Medicine, Radiology, NeuroRadiology, Medical Physics, Santa Maria della Misericordia Hospital, Rovigo, Italy.
Maria Cristina
MC
Marzola
Department of Radiology, University of Southern California, 90033 Los Angeles, USA.
Patrick M
PM
Colletti
Department of Nuclear Medicine, Radiology, NeuroRadiology, Medical Physics, Santa Maria della Misericordia Hospital, Rovigo, Italy. Electronic address: domenico.rubello@libero.it.
Domenico
D
Rubello
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Stefano
S
Fanti
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
FDG PET/ceCT; Lung cancer; Performance