Purpose: Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomogr
aphic (PET) imaging can be a vital tool in the evaluation and preoperative
staging of pulmonary neoplasms, Imaging studies on the gamma camera using c
oincidence PET (co-PET) were introduced recently into clinical practice. Th
is prospective study assessed the efficacy of co-PET for identifying primar
y tumors, mediastinal lymph node involvement, the presence of distant sprea
d, the effect on disease staging, and influence on disease management,
Patients and Methods: Sixty consecutive patients with 61 lung tumors were e
nrolled in the study (36 men, 24 women; age range, 32-87 years; mean age, 6
7 years), Histopathologic confirmation was obtained in 58 patients (59 tumo
rs).
Results: In assessments of a primary lesion to establish its malignant or b
enign nature, the sensitivity rate of co-PET was 96% (53 of 55 lesions), th
e specificity rate was 83% (5 of 6 lesions), and the accuracy rate was 95%
(58 of 61 lesions). In the co-PET assessment of lymph node involvement in w
hich histopathologic confirmation was obtained (n = 32), the sensitivity ra
te was 89% (8 of 9 lesions), the specificity rate was 91% (21 of 23 lesions
), and the accuracy rate was 91% (29 of 32 lesions), Previously unknown dis
tant metastases were correctly identified in eight patients, but five false
-positive lesions were detected in the brain. Disease staging was correctly
altered in 20 patients (33%), and disease management plans were changed in
20 patients (33%) based on the co-PET findings, Unnecessary surgery was ob
viated in six patients (10%). One patient was given the chance for curative
treatment based on the findings of the co-PET study.
Conclusion: The evaluation of patients with lung neoplasms using F-18 FDG c
oincidence detection appears to be reliable.