Benjamin S Halpern MD, Presenter: Nothing to Disclose

Barbara J Fueger MD, Abstract Co-Author: Nothing to Disclose

Wolfgang A Weber MD, Abstract Co-Author: Nothing to Disclose

Christiaan Schiepers MD, Abstract Co-Author: Nothing to Disclose

Osman Ratib MD, Abstract Co-Author: Nothing to Disclose

Johannes Czernin MD, Abstract Co-Author: Nothing to Disclose

18F-FDG PET stages Non-Small Cell Lung Cancer (NSCLC) with high accuracy. The purpose of this study was to determine whether additional gains in diagnostic accuracy arise from integrated PET/CT and software PET and CT image fusion.

Thirty-six patients (17 males and 19 females) with NSCLC underwent staging with an integrated PET/CT (CPS; Knoxville, TN) followed by mediastinal lymph node dissection and tumor resection in 30 patients. 25 of the 36 patients (69%) had separate CT studies within a maximum of 6 six weeks of the integrated PET/CT study. With these images, fully automated image fusion was performed, by using commercially available software. Two blinded reviewers analyzed in consensus all PET images, and an experienced radiologist was subsequently added to assess integrated and software fused PET/CT images. Histo-pathological findings served as “gold standard” for determining the diagnostic accuracy of all modalities.

Reviewers examining PET and integrated PET/CT classified T-stage accurately in 67% (20/30) and 97% (29/30) of patients, respectively (pAutomatic software fusion of separately obtained PET and CT studies was successful in 68% of the patients. In these cases, the results of software fusion with regards to T and N-stage were not different from integrated PET/CT. However, software fusion failed in 32% of the patients.

Integrated PET/CT compared with PET alone was associated with 26% points greater overall diagnostic accuracy. The software fusion method failed to provide acceptable co-registration in >30% of the patients.

Halpern, B, Fueger, B, Weber, W, Schiepers, C, Ratib, O, Czernin, J, Presurgical Comparison of PET, Integrated PET/CT, and Software Image Fusion in Patients with Non-Small Cell Lung Cancer.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411505.html