Nucl Med Mol Imaging.  2016 Jun;50(2):144-149. 10.1007/s13139-015-0387-4.

Clinical Value of a One-Stop-Shop Low-Dose Lung Screening Combined with 18F-FDG PET/CT for the Detection of Metastatic Lung Nodules from Colorectal Cancer

Affiliations
  • 1Department of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center

Abstract

PURPOSE
The aim of this study was to evaluate the clinical usefulness of additional low-dose high-resolution lung computed tomography (LD-HRCT) combined with 18F-fluoro-2-deoxyglucose positron emission tomography with CT (18F-FDG PET)/CT compared with conventional lung setting image of 18F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer.
METHODS
From January 2011 to September 2011, 649 patients with colorectal cancer underwent additional LD-HRCT at maximum inspiration combined with 18F-FDG PET/CT. Forty-five patients were finally diagnosed to have lung metastasis based on histopathologic study or clinical follow-up. Twenty-five of the 45 patients had ≤5 metastatic lung nodules and the other 20 patients had >5 metastatic nodules. One hundred and twenty nodules in the 25 patients with≤5 nodules were evaluated by conventional lung setting image of 18F-FDG PET/CT and by additional LD-HRCT respectively. Sensitivities, specificities, diagnostic accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) of conventional lung setting image of 18F-FDG PET/CT and additional LD-HRCT were calculated using standard formulae. The McNemar test and receiver-operating characteristic (ROC) analysis were performed.
RESULTS
Of the 120 nodules in the 25 patients with ≤5 metastatic lung nodules, 66 nodules were diagnosed as metastatic. Eleven of the 66 nodules were confirmed histopathologically and the others were diagnosed by clinical follow-up. Conventional lung setting image of 18F-FDG PET/CT detected 40 of the 66 nodules and additional LD-HRCT detected 55 nodules. All 15 nodules missed by conventional lung setting imaging but detected by additional LDHRCT were<1 cm in size. The sensitivity, specificity, and diagnostic accuracy of the modalities were 60.6%, 85.2%, and 71.1% for conventional lung setting image and 83.3%, 88.9%, and 85.8% for additional LD-HRCT. By ROC analysis, the area under the ROC curve (AUC) of conventional lung setting image and additional LD-HRCT were 0.712 and 0.827 respectively.
CONCLUSION
Additional LD-HRCT with maximum inspiration was superior to conventional lung setting image of 18F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer (P<0.05).

Keyword

Colorectal cancer; Pulmonary nodule; F-18 FDG; Positron-emission tomography

MeSH Terms

Colorectal Neoplasms*
Fluorodeoxyglucose F18*
Follow-Up Studies
Humans
Lung*
Mass Screening*
Neoplasm Metastasis
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
ROC Curve
Sensitivity and Specificity
Fluorodeoxyglucose F18
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