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Deutsches Institut für Urbanistik
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S. Pauls, A. K. Buck, K. Hohl, G. Halter, M. Hetzel, N. M. Blumstein, F. M. Mottaghy, G. Glatting, S. Krger, L. Sunder-Plassmann, P. Mller, V. Hombach, H.-J. Brambs, S. N. Reske

Improved non-invasive T-Staging in non-small cell lung cancer by integrated 18F-FDG PET/CT

Keywords: NSCLC, PET/CT, PET, MDCT, T-staging

AIM: In this prospective study, reliability of integrated 18F-FDG PET/CT for staging of NSCLC was evaluated and compared to MDCT or PET alone. PATIENTS, METHODS: 240 patients (pts) with suspected NSCLC were examined using PET/CT. Of those patients 112 underwent surgery comprising 80 patients with NSCLC (T1 n = 26, T2 n = 37, T3 n = 11, T4 n = 6). Imaging modalities were evaluated independently. RESULTS: MDCT, PET and PET/CT diagnosed the correct T-stage in 40/80 pts (50%; CI: 0.390.61), 40/80 pts (50%; CI: 0.390.61) and 51/80 pts (64%; CI: 0.520.74), respectively, whereas equivocal T-stage was found in 15/80 pts (19%; CI: 0.110.19), 12/80 pts (15%; CI: 0.080.25) and 4/80 pts (5%; CI: 0.010.12), respectively. With PET/CT, T-stage was more frequently correct compared to MDCT (p = 0.003) or PET (p = 0.019). Pooling stages T1/T2, T-stage was correctly diagnosed with MDCT, PET and PET/CT in 54/80 pts (68%; CI: 0.560.78), 56/80 pts (70%; CI: 0.590.80) and 65/80 pts (81%; CI: 0.710.89). T3 stage was most difficult to diagnose. T3 tumors were correctly diagnosed with MDCT in 2/11 pts (18%; CI: 0.020.52) versus 0/11 pts (0%; CI: 0.000.28) with PET and 5/11 pts (45%; CI: 0.170.77) with PET/CT. In all imaging modalities, there were no equivocal findings for T4 tumors. Of these, MDCT found the correct tumor stage in 4/6 pts (67%; CI: 0.220.95), PET in 3/6 pts (50%; CI: 0.120.88) and PET/CT in 5/6 pts (83%; CI: 0.360.99). CONCLUSION: Integrated PET/CT was significantly more accurate for T-staging of NSCLC compared to MDCT or PET alone. The advantages of PET/CT are especially pronounced combining T1- and T2-stage as well as in advanced tumors.

Nuklearmedizin, Schattauer

Print ISSN: 0029-5566
Volume: 46, 01/2007
Pages: 9 - 14

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