Haijun Wu1, Song Dong2, Xiuhui Li3, Lei Shi4, Dan Shao5, Qing Zhang5, Min Chen6, Yan Cao7, Minn Thant7, Xiaoyu Huang8. 1. Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China. Electronic address: 15876530875@163.com. 2. Department of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China. 3. Department of Information Media Industry, Guangzhou Public Utility Technician College, Guangzhou 510080, Guangdong, PR China. 4. CT Collaboration, Simens Healthcare Ltd. 5. Department of PET Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China. 6. Orthopedics of Traditional Chinese Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China. 7. Department of Radiology, Wayne State University/Detroit Medical Center, Detroit, MI, USA. 8. Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, PR China.
Abstract
OBJECTIVE: To determine the clinical value of 18F-FDG-PET/CT and dual-energy virtual noncalcium CT to detect and identify single osteolytic metastases (SOM) in participants with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Forty-two participants (mean age, 63.5 years ± 10.1; range, 41-81 years) with suspected SOM diagnosed by whole-body 18F-FDG-PET/CT underwent non-enhanced dual-energy CT. All images were visually and quantitatively evaluated by two nuclear medicine physicians (R1 and R2) and two radiologists (R3 and R4) independently. The results of visual and quantitative analysis of 18F-FDG-PET/CT and dual-energy CT were compared with pathological results. RESULTS: In the visual analysis, the specificity and positive predictive value of dual-energy CT for reader 1 and reader 2 is larger than the corresponding figures of18F-FDG-PET/CT for reader 3 and reader 4 (94.1% each vs 82.4%/76.5%; 95.2%/95.0% vs 88.9%/86.2%). The sensitivity and negative predictive value of dual-energy CT is relatively lower than the number of 18F-FDG-PET/CT for readers (80.0%/76.0% vs 96.0%/100.0%; 76.2%/72.7% vs 93.3%/100.0%, respectively). ROI-based analysis of SUVmax on PET/CT images and CT numbers on VNCa images showed a significant difference between metastases and non-metastases (P < 0.001 each). CONCLUSIONS: Pre-surgical evaluation by combination of whole-body 18F-FDG-PET/CT and dual-energy CT could improve the classification of SOM and may further guide the surgical decision-making in participants with NSCLC.
OBJECTIVE: To determine the clinical value of 18F-FDG-PET/CT and dual-energy virtual noncalcium CT to detect and identify single osteolytic metastases (SOM) in participants with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Forty-two participants (mean age, 63.5 years ± 10.1; range, 41-81 years) with suspected SOM diagnosed by whole-body 18F-FDG-PET/CT underwent non-enhanced dual-energy CT. All images were visually and quantitatively evaluated by two nuclear medicine physicians (R1 and R2) and two radiologists (R3 and R4) independently. The results of visual and quantitative analysis of 18F-FDG-PET/CT and dual-energy CT were compared with pathological results. RESULTS: In the visual analysis, the specificity and positive predictive value of dual-energy CT for reader 1 and reader 2 is larger than the corresponding figures of18F-FDG-PET/CT for reader 3 and reader 4 (94.1% each vs 82.4%/76.5%; 95.2%/95.0% vs 88.9%/86.2%). The sensitivity and negative predictive value of dual-energy CT is relatively lower than the number of 18F-FDG-PET/CT for readers (80.0%/76.0% vs 96.0%/100.0%; 76.2%/72.7% vs 93.3%/100.0%, respectively). ROI-based analysis of SUVmax on PET/CT images and CT numbers on VNCa images showed a significant difference between metastases and non-metastases (P < 0.001 each). CONCLUSIONS: Pre-surgical evaluation by combination of whole-body 18F-FDG-PET/CT and dual-energy CT could improve the classification of SOM and may further guide the surgical decision-making in participants with NSCLC.