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J Nucl Med. 2008; 49 (Supplement 1):12P
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General Clinical Specialties: General Practice-Oncology

Lung Malignancies

Measurement of malignant pulmonary nodules using attenuation correction CT from PET/CT scans: Comparison with diagnostic CT of the chest during the re-staging of NSCLC

Richard Jackson1, Partha Sinha1 and Gary Conrad1

1 Diagnostic Radiology, University of Kentucky, Lexington, Kentucky


Formula

45

Objectives: To determine the variance in measurements of malignant pulmonary nodule (PN) size between low-dose attenuation correction CT (AC-CT) and standard protocol diagnostic chest CT.

Methods: Measurements of PN size were obtained from 40 pairs of examinations on 35 consecutive patients who underwent both PET/CT and stand-alone diagnostic chest CT for the re-staging non-small cell lung cancer (NSCLC). All PET scans were performed during quiet breathing on a Siemens Biograph employing an Emotion Duo for the AC-CT. The diagnostic chest CT scans were performed on either: the Biograph (same day but after the PET/CT; Group I); or one of a set of 5 spiral Siemens Somatom / Sensation CT scanners (22% on same day, 52% within 10 days, max. 27 days; Group II). All but 2 of the diagnostic CT examinations were performed using intravenous contrast. The maximum axial diameter of the index PN was used for analysis. Groups I & II were compared using 2-tailed t-test.

Results: Group I had 17 AC-CT and diagnostic CT examinations. Lesion size measured on the AC-CT differed from diagnostic CT by a mean of 3.9% with standard deviation (SD) of 5.2%. Group II had 23 pairs of examinations. Lesions size by AC-CT differed from diagnostic CT by a mean 9.2% with SD of 10.3%. Null hypothesis (that groups I & II are similar) was not rejected (p < 0.07).

Conclusions: Considerable variance exits between measurements of PN size using the AC-CT and using the diagnostic protocol CT. While variances were larger across CT scanners, scanner differences appear less relevant than the technical differences between protocols. Caution should be exercised when using AC-CT measurements for the assessment of stability of pulmonary nodules during the re-staging of NSCLC.





This Article
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Right arrow Articles by Jackson, R.
Right arrow Articles by Conrad, G.
PubMed
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Right arrow Articles by Conrad, G.