Min young Jung MD, Presenter: Nothing to Disclose

Hyun Ju Seon MD, Abstract Co-Author: Nothing to Disclose

Song Choi, Abstract Co-Author: Nothing to Disclose

Yun-Hyeon Kim MD, Abstract Co-Author: Nothing to Disclose

Jae Kyu Kim, Abstract Co-Author: Nothing to Disclose

Jin Gyoon Park, Abstract Co-Author: Nothing to Disclose

Heoung Keun Kang, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To evaluate diagnostic performance of enhanced thoracic CT, fluorodeoxyglucose (FDG)-positron emission tomography (PET), and integrated PET-CT in determining pleural metastasis of patients with non-small cell lung cancer (NSCL) and pleural abnormalities.

75 NSCLC patients with pleural abnormalities on enhanced thoracic CT and following 18 FDG-PET scan was enrolled. We reviewed CT by categorization of pleural abnormalities into the 3 groups such as negative (pleural effusion with attenuation 10 HU or less), indeterminate (pleural effusion with attenuation higher than 10 HU, smooth pleural thickening and/or enhancement or subpleural and/or fissural nodules without pleural effusion), and positive findings (interrupted and nodular enhancing thickening of pleura and/or enhancing pleural nodules with /or without adjacent chest wall or bone invasion) for pleural metastasis. Also reviewed FDG-PET by grading from 0 to 3 as follows: no pleural activity (grade 0), equal or less pleural activity than mediastinal background activity (grade 1), higher pleural activity than mediastinal background activity, but lower than liver activity (grade 2), and higher pleural activity than liver activity (grade 3). Grade 0 and 1 were considered as negative findings and grade 2 and 3 were considered as positive findings. Maximum standardised uptake values (SUVs) of pleural activity were evaluated in integrated PET-CT. Each diagnostic performance of enhanced CT, FDG-PET, and integrated PET-CT was evaluated separately with cytologic and/or histologic diagnosis as standard reference.

There was a significant relation between maximum SUV of pleural activity and pleural metastasis with cutoff value of 3.4 (80% sensitivity and 70% specificity). Sensitivity, specificity, and diagnostic accuaracy in determining pleural metastasis were 66%, 50% and 45% in thoracic CT, 92%, 58%, and 81% in FDG-PET, and 84%, 80%, and 80% in integrated PET-CT with cutoff value of maximum SUV.

18 FDG PET scan or integrated PET-CT (maximum SUV) have better diagnostic performance than enhanced thoracic CT in determining pleural metastasis in patients with NSCLC.

Integrated PET-CT (maximum SUV) can be most useful diagnostic method in determining pleural metastasis in patients with NSCLC.

Jung, M, Seon, H, Choi, S, Kim, Y, Kim, J, Park, J, Kang, H, et al, , Determination of Pleural Metastasis in Non-small Cell Lung Cancer: Diagnostic Performance of Enhanced Thoracic CT, FDG-PET, and Integrated PET-CT.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6021390.html