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Radiology, Vol 191, 371-377, Copyright © 1994 by Radiological Society of North America

ARTICLES

Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation

RL Wahl, LE Quint, RL Greenough, CR Meyer, RI White and MB Orringer
Department of Internal Medicine (Division of Nuclear Medicine), University of Michigan Medical Center, Ann Arbor 48109-0028.

PURPOSE: To evaluate use of positron emission tomography (PET) with 2- [fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) in detection of mediastinal lymph node metastases from non-small cell lung cancer. MATERIALS AND METHODS: A prospective trial to compare FDG PET and computed tomography (CT) of the thorax was performed in 23 patients with newly diagnosed or suspected non-small cell lung cancer. Blinded interpretations of CT alone, PET alone, CT and PET together, and fusion images were performed, and the results were compared with pathologic results. RESULTS: Nineteen of 23 patients had non-small cell lung cancer. Prevalence of mediastinal involvement was 41%. In staging disease in the mediastinum, CT alone was 64% sensitive, 44% specific, and 52% accurate, whereas PET alone and fusion images were 82% sensitive, 81% specific, and 81% accurate (P < .05). CONCLUSIONS: FDG PET was more accurate than CT in staging disease in the mediastinum in patients with lung cancer and appears to be the preferred imaging method in this clinical setting.


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