Accuracy of standardized uptake value measured by simultaneous emission and transmission scanning in PET oncology

224

107

BACKGROUNDThe purpose of the current study was to assess whether [18F]fluorodeoxyglucose positron emission tomography (FDG‐PET) provides incremental value (e.g., additional information on lymph node involvement or the presence of distant metastases) compared with computed tomography (CT) in patients with esophageal carcinoma.METHODSThe authors examined 149 consecutive patients with thoracic esophageal carcinoma. Eighty‐one patients underwent radical esophagectomy without pretreatment, 17 received chemoradiotherapy followed by surgery, 3 underwent endoscopic mucosal resection, and the remaining 48 patients received definitive radiotherapy and chemotherapy. The diagnostic accuracy of FDG‐PET and CT was evaluated at the time of diagnosis.RESULTSThe primary tumor was visualized using FDG‐PET in 119 (80%) of 149 patients. Regarding lymph node metastases, FDG‐PET had 32% sensitivity, 99% specificity, and 93% accuracy for individual lymph node group evaluation and 55% sensitivity, 90% specificity, and 72% accuracy for lymph node staging evaluation. PET exhibited incremental value over CT with regard to lymph node status in 14 of 98 patients who received surgery: 6 patients with negative CT findings were eventually shown to have lymph node metastases (i.e., they had positive PET findings and a positive reference standard [RS]); 6 patients with positive CT findings were shown not to have lymph node metastases (i.e., they had negative PET findings and a negative RS); and 2 patients were shown to have cervical lymph node metastases in addition to mediastinal or abdominal lymph node metastases. Among the remaining patients, PET showed incremental value over CT with regard to distant organ metastases in six patients. The overall incremental value of PET compared with CT with regard to staging accuracy was 14% (20 of 149 patients).CONCLUSIONSFDG‐PET provided incremental value over CT in the initial staging of esophageal carcinoma. At present, combined PET‐CT may be the most effective method available for the preoperative staging of esophageal tumors. Cancer 2005. © 2004 American Cancer Society.

Section: Pet Imagingmentioning

confidence: 99%

The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

Kato

Miyazaki

Nakajima

et al. 2004

224

107

“…Patients fasted for at least 4 hours before FDG-PET scanning. The FDG-PET imaging protocols had been approved by the institutional review board of our institute, 17 and all patients gave informed consent before undergoing the examination.…”

Section: Pet Imagingmentioning

confidence: 99%

“…For primary lesions that were nonvisualized on PET imaging, the ROIs were drawn over the corresponding area by using a fusion image technique combined with the CT and magnetic resonance imaging images. 17 Similarly, for affected regional lymph nodes that were not visualized on PET imaging, ROIs 0.6 cm in dimension were drawn on the corresponding area by using the fusion image combined with CT images. A background ROI of the same dimension as that of the lesion-based ROI was drawn over the corresponding symmetrically opposite area.…”

Section: Pet Imagingmentioning

confidence: 99%

Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma

Kato

Kuwano

Nakajima

et al. 2002

277

“…21 The PET images were obtained using a PET scanner (SET2400W; Shimadzu, Kyoto, Japan) with a 59.5-cm transaxial field of view and a 20-cm axial field of view. The spatial resolution was 4.2 mm full-width half-maximum (FWHM) at the center of the field of view, and the axial resolution was 5.0 mm FWHM.…”

mentioning

confidence: 99%

“…The FDG-PET protocols were approved by the Institutional Review Board of Gunma University. 21 Attenuation-corrected transaxial images were reconstructed by using the ordered subset-expectation maximization algorithm into 128 3 128 matrices with pixel dimensions of 4.0 mm in plane and 3.125 mm axially. Finally, every 3 consecutive slices were summed to generate a 9.8-mm-thick transaxial image that was used for visual interpretation and quantitative analysis.…”

mentioning

confidence: 99%

The usefulness of ¹⁸F‐fluorodeoxyglucose positron emission tomography (¹⁸F‐FDG‐PET) and a comparison of ¹⁸F‐FDG‐pet with ⁶⁷gallium scintigraphy in the evaluation of lymphoma

Tsukamoto

Kojima

Hasegawa

et al. 2007

189

101

BACKGROUND.Although studies comparing conventional imaging modalities with 18F‐fluorodeoxyglucose positron emission tomography (18F‐FDG‐PET) for the detection of lymphoma and although the relations between 18F‐FDG‐PET and histologic types were reported previously, most studies were not systematic and involved relatively small numbers of patients.METHODS.Two hundred fifty‐five patients with lymphoma had their disease staged using 18F‐FDG‐PET, and 191 of those patients also were assessed using gallium‐67 scintigraphy (67Ga). Disease sites were identified on a site‐by‐site basis using computed tomography scans and/or magnetic resonance imaging. The results of these conventional imaging modalities were compared with the results from 8F‐FDG‐PET and 67Ga, and correlations between the imaging results and pathologic diagnoses were evaluated by using the World Health Organization classification system.RESULTS.Of 913 disease sites in 255 patients, 18F‐FDG‐PET identified >97% of disease sites of Hodgkin lymphoma (HL) and aggressive and highly aggressive non‐Hodgkin lymphoma. For indolent lymphoma, the detection rate of 18F‐FDG‐PET was 91% for follicular lymphoma (FL); 82% for extranodal marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue, irrespective of plasmacytic differentiation; and approximately 50% for small lymphocytic lymphoma (SLL) and splenic marginal zone lymphoma (SMZL). The results from 67Ga were similar to those from 18F‐FDG‐PET for most histologic subtypes. However, the sensitivity of 67Ga was unexpectedly poor for FL, for mantle cell lymphoma (MCL), and for the nasal type of natural killer/T‐cell lymphoma (NK/T‐nasal), ranging from 30% to 38%.CONCLUSIONS.18F‐FDG‐PET was useful for all histologic subtypes of lymphoma other than SLL and SMZL. Compared with 67Ga, the authors strongly recommend the use of 18F‐FDG‐PET in patients with FL, MCL, and NK‐nasal. Cancer 2007. © 2007 American Cancer Society.