Comput tomography (CT) and positron...

Comput tomography (CT) and positron-emission tomography (PET) commonly are used in the initial staging of lung cancer and other malignancies. While CT can provide of the highest order detail on the size and location of tumor masses and adjacent lymph nodes, it sometimes cannot differentiate between benign and malignant tissue. angry mood uses radiotracers to mark areas of increased uptake in malignant tissue nevertheless has limited spatial resolution. Side-by-side visual comparison of CT and especially liked scans, although often employed in cancer staging, is laborious and may be inexact. A modern innovation in tumor imaging is the use of integrated PET-CT scanners that provide precisely overlayed images. Lardinois and colleagues report forward the comparative diagnostic accuracy of separate and combined CT and miff imaging for the staging of non-small-cell lung cancer.

The authors studied 50 consecutive patients with suspected or proven lung cancer who were referr for surgery at a university hospital. Conventional staging was done with standard modalities, including bronchoscopy and line testing. Each patient underwent whole-body imaging in a combined PET-CT scanner. Separate fondling and CT images were produc as well as a combined overlay. single in kind patient was excluded when biopsy flows indicated lymphoma, not lung cancer. Mediastinal lymph node dissection was performed in 35 patients. Those with widely metastatic disease or no nodes larger than 5 mm did not have surgical lymph node exploration.

When compared with visual correlation of separate favorite and CT scans, combined PET-CT images provided additional information that changed clinical management in 41 percent of patients. Among the additional findings seen with combined imaging were otherwise undetect local and wide metastatic tumor spread, differentiation of malignant tissue from adjacent lung inflammation and atelectasis, and more precise location of lymph node positions.

Integrated PET-CT was the greatest in quantity accurate preoperative method for disease classification, correctly staging the disease compared with the postsurgical diagnosis in 88 percent of cases. fondling alone correctly classified 40 percent CT alone 58 percent and visually correlated separate fondling and CT scans were correct in 65 percent of patients. Of the nine patients incorrectly classified through visual correlation of separate scans, eight were correctly staged at the combined PET-CT images.

The authors close that integrated PET-CT improved the diagnostic accuracy of non-small-cell lung cancer staging when compared with separate scans.

Lardinois D et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and comput tomography. N Engl J M June 19 2003;348: 2500-7

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group