Department of Radiology, University of Michigan Hospitals, Ann Arbor, MI 48109, United States.
Lung Cancer. 2011 Jul;73(1):59-62. doi: 10.1016/j.lungcan.2010.10.021. Epub 2010 Nov 20.
To determine the optimal anatomic coverage at CT that would provide the most accurate staging for patients with non-small cell lung cancer.
We reviewed lung cancer staging PET-CT scans and correlated them with staging chest CT scans performed within 50 days of the PET-CT study. There were 113 patients who underwent both studies within our time frame. We reviewed the results of subsequent imaging studies and surgical and biopsy procedures to determine the final stage for each patient. This study was approved by the local institutional review board.
In 86 (76%) of 113 patients, staging by PET-CT and by CT from the lung apices through the lung bases was identical. PET-CT upstaged 21 patients (19%) compared with CT findings; in 13 of these patients the PET-CT noted disease that was either outside of the anatomic range of any lung cancer staging CT or was within the area scanned by CT, but was not evident by CT. In the other 8 upstaged patients, extending the anatomic scope of the CT scan to the supraclavicular region (5), adrenal glands (2) or abdomen (1) would have resulted in correct staging.
CT scanning from the supraclavicular region through the caudal adrenal glands improves the accuracy of CT staging of lung cancer compared with scanning from the lung apices through the lung bases. Anatomic coverage beyond the adrenal glands has a low yield for improved staging, at the cost of requiring administration of oral contrast to all patients.
To determine the optimal anatomic coverage at CT that would provide the most accurate staging for patients with non-small cell lung cancer, we reviewed lung cancer staging PET-CT scans and correlated them with staging chest CT scans performed within 50 days of the PET-CT study. CT scanning from the supraclavicular region through the caudal adrenal glands improves the accuracy of CT staging of lung cancer compared with scanning from the lung apices through the lung bases. Anatomic coverage beyond the adrenal glands has a low yield for improved staging, at the cost of requiring administration of oral contrast to all patients undergoing lung cancer staging.
确定 CT 最佳解剖覆盖范围，为非小细胞肺癌患者提供最准确的分期。
我们回顾了肺癌分期 PET-CT 扫描，并将其与 PET-CT 研究后 50 天内进行的分期胸部 CT 扫描进行了相关性分析。在我们的时间框架内，共有 113 例患者同时进行了这两项研究。我们回顾了随后的影像学研究和手术及活检程序的结果，以确定每位患者的最终分期。本研究获得了当地机构审查委员会的批准。
在 113 例患者中，86 例（76%）患者的 PET-CT 分期与从肺尖至肺底的 CT 分期完全一致。与 CT 结果相比，PET-CT 分期上调了 21 例（19%）患者；在这 13 例患者中，PET-CT 检测到的疾病要么位于任何肺癌分期 CT 的解剖范围之外，要么位于 CT 扫描区域内，但 CT 未显示。在另外 8 例分期上调的患者中，如果将 CT 扫描的解剖范围扩展到锁骨上区域（5 例）、肾上腺（2 例）或腹部（1 例），则可以进行正确的分期。
与从肺尖至肺底进行 CT 扫描相比，从锁骨上区域至尾侧肾上腺进行 CT 扫描可提高肺癌 CT 分期的准确性。在提高分期的效果方面，超越肾上腺的解剖覆盖范围的效果不佳，但代价是需要对所有肺癌分期患者使用口服对比剂。
为了确定 CT 最佳解剖覆盖范围，为非小细胞肺癌患者提供最准确的分期，我们回顾了肺癌分期 PET-CT 扫描，并将其与 PET-CT 研究后 50 天内进行的分期胸部 CT 扫描进行了相关性分析。与从肺尖至肺底进行 CT 扫描相比，从锁骨上区域至尾侧肾上腺进行 CT 扫描可提高肺癌 CT 分期的准确性。在提高分期的效果方面，超越肾上腺的解剖覆盖范围的效果不佳，但代价是需要对所有肺癌分期患者使用口服对比剂。
