Capabilities of two- and three-dimensional FDG-PET for detecting small lesions and lymph nodes in the upper torso: a dynamic phantom study

Abstract. The capabilities and limitations of two-(2D) and three-dimensional (3D) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting small tumors and lymph nodes were studied in a phantom modeling the human chest and axilla. Multiple dual-radionuclide phantom studies were performed. Five hollow spheres ranging in diameter from 3 mm to 15 mm were filled with carbon-11 and placed in the axillary and mediastinal regions of an anthropomorphic phantom containing hollow organs filled with 18F to simulate FDG uptake 1 h after injection. Dynamic imaging was performed to acquire PET images with varying target-to-background ratios. Imaging was performed in 2D and 3D acquisition modes, with and without attenuation correction, on a modern PET scanner. Lesion detectability was visually and quantitatively assessed. For objects larger than 9 mm in diameter, target-to-background ratios ranging from ∼3:1 to ∼10:1 were detectable. Objects < 9 mm in diameter required a target-to-background ratio of ≥18:1. Target-to-background ratios required for lesion detectability were equivalent for 2D and 3D PET images with and without attenuation correction. In conclusion, 2D and 3D PET with attenuation correction consistently detected ”tumors”≥ 9 mm. Lesions < 9 mm could be detected if there was high enough tumor uptake. No statistically significant differences in lesion detection were found for 2D versus 3D PET, or for attenuation-corrected versus non-attenuation-corrected images.

[1]  P. Valk,et al.  Staging non-small cell lung cancer by whole-body positron emission tomographic imaging. , 1995, The Annals of thoracic surgery.

[2]  E. Hoffman,et al.  Quantitation in Positron Emission Computed Tomography: 1. Effect of Object Size , 1979, Journal of computer assisted tomography.

[3]  T Ido,et al.  Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[4]  M Schwaiger,et al.  Comparison of fluorine-18-fluorodeoxyglucose PET, MRI and endoscopy for staging head and neck squamous-cell carcinomas. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[5]  M. Greco,et al.  Prospective evaluation of fluorine-18-FDG PET in presurgical staging of the axilla in breast cancer. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  E H Moore,et al.  Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. , 1992, Radiology.

[7]  G. Hortobagyi,et al.  Positron emission tomography with fluorine‐18‐deoxyglucose in the detection and staging of breast cancer , 1993, Cancer.

[8]  R. Kessler,et al.  Analysis of emission tomographic scan data: limitations imposed by resolution and background. , 1984, Journal of computer assisted tomography.

[9]  R L Wahl,et al.  Untreated lung cancer: quantification of systematic distortion of tumor size and shape on non-attenuation-corrected 2-[fluorine-18]fluoro-2-deoxy-D-glucose PET scans. , 1996, Radiology.

[10]  M. Orringer,et al.  Bronchogenic carcinoma metastatic to normal-sized lymph nodes: frequency and significance. , 1988, Radiology.

[11]  R. Coleman,et al.  Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning. , 1993, Radiology.

[12]  A. Rosenberg,et al.  CT-pathologic correlation of axillary lymph nodes in breast carcinoma. , 1991, Journal of computer assisted tomography.

[13]  K. Mori,et al.  Mediastinal lymph node metastasis from lung cancer: evaluation with Tl-201 SPECT--comparison with CT. , 1994, Radiology.

[14]  V J Lowe,et al.  Lung tumor growth correlates with glucose metabolism measured by fluoride-18 fluorodeoxyglucose positron emission tomography. , 1995, The Annals of thoracic surgery.

[15]  B. McNeil,et al.  CT and MR imaging in the staging of colorectal carcinoma: report of the Radiology Diagnostic Oncology Group II. , 1996, Radiology.

[16]  R L Wahl,et al.  Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose: variations with body weight and a method for correction. , 1993, Radiology.

[17]  H. Tonami,et al.  Comparison of fluorine-18-FDG PET and thallium-201 SPECT in evaluation of lung cancer. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[18]  A. Bogni,et al.  The Contribution of Positron Emission Tomography (Pet) with 18F-Fluorodeoxyglucose (Fdg) in the Preoperative Detection of Axillary Metastases of Breast Cancer: The Experience of the National Cancer Institute of Milan , 1997, Tumori.

[19]  N. Gupta,et al.  Positron emission tomography of lung tumors and mediastinal lymph nodes using [18F]fluorodeoxyglucose , 1994 .

[20]  R L Wahl,et al.  Primary and metastatic breast carcinoma: initial clinical evaluation with PET with the radiolabeled glucose analogue 2-[F-18]-fluoro-2-deoxy-D-glucose. , 1991, Radiology.

[21]  M P Frick,et al.  Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management. , 1993, Chest.

[22]  R. Wahl,et al.  Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation. , 1994, Radiology.

[23]  R L Wahl,et al.  Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]-fluoro-2-deoxy-D-glucose uptake at PET. , 1995, Radiology.

[24]  M. Mandelkern,et al.  Fluorodeoxyglucose-positron emission tomography in the detection and staging of lung cancer. , 1996, American journal of respiratory and critical care medicine.

[25]  R. Castellino,et al.  Computed tomography, lymphography, and staging laparotomy: correlations in initial staging of Hodgkin disease. , 1984, AJR. American journal of roentgenology.

[26]  J L Roodenburg,et al.  Detection of lymph node metastases of squamous-cell cancer of the head and neck with FDG-PET and MRI. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[27]  J M Hoffman,et al.  Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[28]  Tsuneo Matsumoto,et al.  Bronchogenic carcinoma: incidence of metastases to normal sized lymph nodes. , 1995, Thorax.

[29]  C. Stearns,et al.  Investigation of the count rate performance of the General Electric Advance positron emission tomograph , 1994, Proceedings of 1994 IEEE Nuclear Science Symposium - NSS'94.

[30]  G. Urso,et al.  Role of positron emission tomography in staging esophageal cancer. , 1997, The Annals of thoracic surgery.

[31]  J. Sunderland,et al.  Mediastinal lymph node staging of non-small-cell lung cancer: a prospective comparison of computed tomography and positron emission tomography. , 1996, The Journal of thoracic and cardiovascular surgery.

[32]  P. Vogel,et al.  [Correlation of lymph node size and metastatic involvement of lymph nodes in bronchial cancer]. , 1990, Langenbecks Archiv fur Chirurgie.

[33]  J. Zubieta,et al.  Influence of spatially heterogeneous background activity on "hot object" quantitation in brain emission computed tomography. , 1996, Journal of computer assisted tomography.

[34]  M E Phelps,et al.  The application of positron emission tomographic imaging with fluorodeoxyglucose to the evaluation of breast disease. , 1992, Annals of surgery.

[35]  Thomas K. Lewellen,et al.  Investigation of the performance of the General Electric Advance positron emission tomograph in 3D mode , 1995 .