Emilio Quaia MD, Presenter: Nothing to Disclose

Giuseppe Tona MD, Abstract Co-Author: Nothing to Disclose

Fabio Gelain, Abstract Co-Author: Nothing to Disclose

Ermanno Boscolo, Abstract Co-Author: Nothing to Disclose

Luigi Bussoli, Abstract Co-Author: Nothing to Disclose

To compare fluorine 18 Flurodeoxyglucose positron emission tomography combined to computed tomography (F-18 FDG - PET/CT) and contrast material-enhanced CT in characterization and nodal staging of pulmonary lesions.

76 consecutive patients (56 male and 20 female; mean age ± SD, 63.4 ± 20 years) with 84 solid pulmonary lesions, 1-8 cm in diameter, identified by chest plain film (n=72) or CT (n=12) were included. All patients underwent whole body FDG – PET/CT and contrast material-enhanced CT. FDG – PET/CT consisted in non-enhanced spiral CT 60 min after injection of 370 MBq of 18F-FDG followed by FDG-PET imaging covering the neck, thorax, abdomen and pelvis. Two readers reviewed in consensus separated and fused FDG-PET/CT images, while 2 other readers reviewed contrast material-enhanced CT images. Pulmonary lesions were characterized as malignant or benign according to standardized uptake value (SUV) > 2.5 in FDG-PET/CT, and reference standard criteria in contrast material-enhanced CT. Histology from surgical or bioptic specimen was employed for final characterization of lesions. For nodal (N) staging, histopathological diagnosis served as reference in patients (n= 75) who underwent resective surgery with extensive N1 and N2 lymph nodes sampling/dissection. Surgical sampling included an average of 6 lymph node stations of mediastinum.

Reference procedures revealed 72 malignant tumors (38 adenocarcinomas, 18 squamous carcinomas, 3 adenosquamous carcinomas, 3 lymphomas, 2 microcytomas, 2 carcinoids and 6 metastases) and 12 benign benign tumors (3 hamartomas, 3 sarcoidosis, 1 amyloidosis, 1 Wegener granulomatosis, 1 tuberculosis, and 3 scars with diffuse fibrosis). In lesions characterization the sensitivity of FDG - PET/CT was 91.6% and specificity 16.6% (contrast material-enhanced CT = 84.7% and 58.3%; P < 0.05, McNemar test). In N staging the sensitivity of FDG - PET/CT was 76%, and specificity 80% (contrast material-enhanced CT = 48% and 92%; P < 0.05, McNemar test).

FDG-PET/CT compared to contrast material-enhanced CT revealed lower specificity in pulmonary lesions characterization and higher sensitivity in N staging.

Quaia, E, Tona, G, Gelain, F, Boscolo, E, Bussoli, L, Fluorine-18 Flurodeoxyglucose Positron Emission Tomography Combined to Computed Tomography (F-18 FDG - PET/CT) Compared to Contrast Material-enhanced CT for Characterization and Nodal Staging of Pulmonary Lesions: Analysis of Diagnostic Performance.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4404432.html