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[Accuracy of positron emission tomography with fluorine-18-fluoro-deoxyglucose]
D Hellwig1, A Gröschel, K Rentz
1Abteilung Nuklearmedizin der Radiologischen Universitätsklinik Homburg/Saar, Germany. Dirk.Hellwig@med-rz.uni-saarland.de
Background:
: FDG-PET is a powerful tool for the diagnostic workup of patients with lung cancer. A reduced sensitivity of FDG-PET for the evaluation of lung lesions was reported for bronchioloalveolar carcinoma (BAC). No literature exists about the diagnostic efficacy of FDG-PET in the staging of BAC.
Methods:
: Out of a series of subsequent 630 untreated patients with the final diagnosis of lung cancer, who underwent FDG-PET, all patients with BAC were evaluated with respect to tumour detection, N-staging, and M-staging.
Results:
: 35 patients (5.6 %) had BAC, 22 in a localized form (8 x pT1, 14 x pT2), 13 in a disseminated stage. FDG-PET correctly identified 19/22 cases with localized forms. Two of the missed one were classified as pT1. All disseminated forms of BAC were detected. Standardized uptake values (SUV) ranged from 0.9 to 23.3 (mean +/- SD: 11.6 +/- 5.1). Accuracy of N-staging was comparable to known results in lung cancer (FDG-PET 80 %, CT 64 %). With respect to M-staging, sensitivity of FDG-PET was as follows: M1(HEP): 2/3 (67 %), M1(PUL): 7/8 (88 %), M1(OSS): 1/1 (100 %).
Conclusions:
: With some limitations in small localized tumours FDG-PET can detect and stage BAC with an accuracy which is identical to that for other histological types of non-small cell lung cancer.