Dual time point imaging for F18-FDG-PET/CT does not improve the accuracy of nodal staging in non-small cell lung cancer patients
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Dual time point imaging for F18-FDG-PET/CT does not improve the accuracy of nodal staging in non-small cell lung cancer patients. / Rogasch, Julian M M; Steffen, Ingo G; Riedel, Sandra; Apostolova, Ivayla; Wertzel, Heinz; Achenbach, H Jost; Steinkrüger, Ferdinand L G A; Kalinski, Thomas; Schultz, Meinald; Schreiber, Jens; Amthauer, Holger; Furth, Christian.
in: EUR RADIOL, Jahrgang 26, Nr. 8, 08.2016, S. 2808-18.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Dual time point imaging for F18-FDG-PET/CT does not improve the accuracy of nodal staging in non-small cell lung cancer patients
AU - Rogasch, Julian M M
AU - Steffen, Ingo G
AU - Riedel, Sandra
AU - Apostolova, Ivayla
AU - Wertzel, Heinz
AU - Achenbach, H Jost
AU - Steinkrüger, Ferdinand L G A
AU - Kalinski, Thomas
AU - Schultz, Meinald
AU - Schreiber, Jens
AU - Amthauer, Holger
AU - Furth, Christian
PY - 2016/8
Y1 - 2016/8
N2 - OBJECTIVES: To analyze the diagnostic performance of dual time point imaging (DTPI) for pre-therapeutic lymph node (LN) staging in non-small cell lung cancer (NSCLC).METHODS: This was a retrospective analysis of 47 patients with NSCLC who had undergone DTPI by PET (early + delayed) using F18-fluorodeoxyglucose (FDG). PET raw data were reconstructed iteratively (point spread function + time-of-flight). LN uptake in PET was assessed visually (four-step score) and semi-quantitatively (SUVmax, SUVmean, ratios LN/primary, LN/liver, and LN/mediastinal blood pool). DTPI analyses included retention indices (RIs), Δ-ratios and changes in visual score. Histology or cytology served as standards of reference. Accuracy was determined based on ROC analyses.RESULTS: Thirty-six of 155 LNs were malignant. DTPI accuracy was low for all measures (visual assessment, 24.5%; RI SUVmax, 68.4%; RI SUVmean, 65.8%; Δ-ratios, 63.9-76.1%) and significantly inferior to early PET. Accuracies of early (range, 86.5-92.9%) and delayed PET (range, 85.2-92.9%) were comparable. At early PET, accuracy of the visual score (92.9%) was similar or superior to semi-quantitative analyses (range, 86.5-92.3%).CONCLUSIONS: Using a modern PET/CT device and novel image reconstruction, neither additional delayed PET nor DTPI analyses improved the accuracy of PET-based LN staging. Dedicated visual assessment criteria performed very well.KEY POINTS: • DTPI did not improve accuracy of PET-based LN staging in NSCLC. • Analyzed SUV ratios were not superior to LN SUVmax or SUVmean. • A four-step visual score may allow highly accurate, standardized LN assessment.
AB - OBJECTIVES: To analyze the diagnostic performance of dual time point imaging (DTPI) for pre-therapeutic lymph node (LN) staging in non-small cell lung cancer (NSCLC).METHODS: This was a retrospective analysis of 47 patients with NSCLC who had undergone DTPI by PET (early + delayed) using F18-fluorodeoxyglucose (FDG). PET raw data were reconstructed iteratively (point spread function + time-of-flight). LN uptake in PET was assessed visually (four-step score) and semi-quantitatively (SUVmax, SUVmean, ratios LN/primary, LN/liver, and LN/mediastinal blood pool). DTPI analyses included retention indices (RIs), Δ-ratios and changes in visual score. Histology or cytology served as standards of reference. Accuracy was determined based on ROC analyses.RESULTS: Thirty-six of 155 LNs were malignant. DTPI accuracy was low for all measures (visual assessment, 24.5%; RI SUVmax, 68.4%; RI SUVmean, 65.8%; Δ-ratios, 63.9-76.1%) and significantly inferior to early PET. Accuracies of early (range, 86.5-92.9%) and delayed PET (range, 85.2-92.9%) were comparable. At early PET, accuracy of the visual score (92.9%) was similar or superior to semi-quantitative analyses (range, 86.5-92.3%).CONCLUSIONS: Using a modern PET/CT device and novel image reconstruction, neither additional delayed PET nor DTPI analyses improved the accuracy of PET-based LN staging. Dedicated visual assessment criteria performed very well.KEY POINTS: • DTPI did not improve accuracy of PET-based LN staging in NSCLC. • Analyzed SUV ratios were not superior to LN SUVmax or SUVmean. • A four-step visual score may allow highly accurate, standardized LN assessment.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Non-Small-Cell Lung
KW - Female
KW - Fluorodeoxyglucose F18
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Lung Neoplasms
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Positron Emission Tomography Computed Tomography
KW - ROC Curve
KW - Radiopharmaceuticals
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Journal Article
U2 - 10.1007/s00330-015-4093-5
DO - 10.1007/s00330-015-4093-5
M3 - SCORING: Journal article
C2 - 26560731
VL - 26
SP - 2808
EP - 2818
JO - EUR RADIOL
JF - EUR RADIOL
SN - 0938-7994
IS - 8
ER -
