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1.
Mol Imaging Biol ; 7(5): 369-76, 2005.
Article in English | MEDLINE | ID: mdl-16220355

ABSTRACT

PURPOSE: This study was conducted to compare the clinical stage derived from 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography (PET) to that of integrated PET/computed tomography (CT) in restaged breast cancer patients. PROCEDURES: Fifty-eight female patients (age range 29-80 years, mean age +/-SD, 53.3 +/- 11.7 years) underwent PET/CT restaging for breast cancer. Two experienced nuclear medicine physicians interpreted PET images. A radiologist was added for reading PET/CT studies. A patient-based analysis was performed. Histopathological findings, correlative imaging studies, changes in number, size, and hypermetabolic activity of suspicious lesions and/or patient outcome served as standard of reference for determining the diagnostic accuracy of both modalities. RESULTS: PET staged 79.3% (46/58) of the patients correctly, overstaged seven (12.1%), and understaged five patients (8.6%). Integrated PET/CT staged 89.7% (52/58) of the patients correctly, overstaged four (6.9%), and understaged two patients (3.4%). The staging accuracy of PET/CT was not significantly better than that of PET alone (p = 0.059). Lesions exhibiting mild hypermetabolic activity, benign inflammatory lesions, and physiological variants largely explained incorrect PET findings. CONCLUSION: Integrated PET/CT only marginally improves the restaging accuracy over PET alone (p = 0.059) in breast cancer patients.


Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/diagnosis , Fluorodeoxyglucose F18 , Positron-Emission Tomography/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Neoplasm Metastasis/diagnostic imaging , Neoplasm Metastasis/pathology , Neoplasm Staging , Positron-Emission Tomography/standards , Sensitivity and Specificity , Tomography, X-Ray Computed
2.
Chest ; 128(4): 2289-97, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16236886

ABSTRACT

PURPOSES: To compare the diagnostic accuracy of positron emission tomography (PET) and integrated PET/CT and to evaluate the performance of software fusion for staging of non-small cell lung cancer (NSCLC). METHODS: Thirty-six patients (17 men and 19 women) with NSCLC underwent staging with integrated PET/CT followed by mediastinal lymph node dissection and tumor resection. Twenty-five of the 36 patients (69%) underwent separate CT studies for software fusion of images. Two blinded reviewers analyzed in consensus all PET images, and an experienced radiologist was added to assess integrated and software-fused PET/CT images. Histopathologic findings served as "gold standard" for determining the diagnostic accuracy of all modalities. RESULTS: Reviewers examining PET and integrated PET/CT classified T stage accurately in 67% (20 of 30 patients) and 97% (29 of 30 patients), respectively (p < 0.05). Overall, interpretations based on PET staged 57% (17 of 30 patients) correctly, over-staged 6 patients (20%), and under-staged 7 patients (23%). Interpretations based on integrated PET/CT correctly staged 83% (25 of 30 patients), over-staged 3 patients (10%), and under-staged 2 patients (7%). The overall staging accuracy of integrated PET/CT was significantly higher than that of PET (p < 0.05). Automatic software fusion of separately obtained PET and CT studies was successful in 68% of the patients but failed in 32%. In successful software fusion cases, the results of software fusion with regards to T stage and N stage were not different from integrated PET/CT. CONCLUSIONS: Integrated PET/CT compared with PET alone was associated with 26% points-greater overall diagnostic accuracy (p = 0.01). The software fusion method failed to provide acceptable co-registration in > 30% of the patients.


Subject(s)
Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Lymph Node Excision , Neoplasm Staging , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/surgery , Female , Humans , Image Processing, Computer-Assisted , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Lymphatic Metastasis , Male , Neoplasm Staging/methods , Positron-Emission Tomography , Preoperative Care , Radiography , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Software
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