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Vol.46 No.1 contents | Japanese/English |
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- The 31st Diagnostic Imaging Seminar -
The Usefulness and Problems of FDG-PET for Managing the Patients With Lung Cancer
Masaki Hara1, Norio Shiraki1, Masanori Kitase2, Hidekazu Oshima2, Hiroko Tsuji2, Mayumi Kume2, Yuta Shibamoto2, Tsuneo Tamaki3, Masami Nishio41,2Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan, 3Department of Radiology, Nagoya Kyoritsu Hospital, Japan, 4Nagoya PET Imaging Center, Japan
Recently PET systems have been introduced at many institutions throughout Japan and the clinical importance should contribute to the management of many kinds of malignant diseases, particularly using 2- [fluorine-18] fluoro-2-deoxy-D-glucose (FDG). Since March 2004 we have operated the first PET/CT scanner in Japan with a 4-slice multi-detector CT (MDCT) and we have now introduced a second PET/CT scanner with 8-slice MDCT because of its excellent diagnostic ability and higher throughput capacity than that of an ordinary PET scanner. The diagnositic accuracy of FDG-PET was initially highly regarded, but now some problems have been defined based on extensive experiences. It is usually difficult to distinguish malignant from benign lesions using FDG-PET except for large lesions or lesions with markedly elevated FDG accumulation. FDG accumulation in small lesions decreases to an intermediate level because of the partial volume effect even in lesions with high glucose metabolism. It is important to investigate FDG-PET findings together with the morphological characteristics obtained using CT and/or MRI. For diagnosing nodal status, FDG-PET has been considered superior to CT. However for potentially operable patients, FDG-PET might show considerable false-positive or false-negative results. FDG-PET should be useful for integrating and simplifying many kinds of tools to determine the existence of distant metastases. In this paper we demonstrate the present features of FDG-PET for staging in patients with lung cancer.
key words: PET/CT, FDG-PET, Lung cancer, Staging
JJLC 46 (1): 65-74, 2006
