Improved Image Interpretation with Registered Thoracic CT and Positron Emission Tomography Data Sets
Suzanne L. Aquino1,
Jane C. Asmuth2,
Richard H. Moore1,
Steven B. Weise1 and
Alan J. Fischman1
1
Department of Radiology, FND 202, Massachusetts General Hospital, 55 Fruit
St., Boston, MA 02114.
2
Sarnoff Corporation, 201 Washington Rd., Princeton, NJ 08540.
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Fig. 1A. —67-year-old man (patient 2) who received radiation and
chemotherapy for non—small cell carcinoma of lung. Coronal (A)
and axial (B) images of FDG positron emission tomography (PET) scan
show area of increased FDG uptake (arrows) in right apex. Tumor could
not be distinguished from radiation changes on PET interpretation.
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Fig. 1B. —67-year-old man (patient 2) who received radiation and
chemotherapy for non—small cell carcinoma of lung. Coronal (A)
and axial (B) images of FDG positron emission tomography (PET) scan
show area of increased FDG uptake (arrows) in right apex. Tumor could
not be distinguished from radiation changes on PET interpretation.
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Fig. 1C. —67-year-old man (patient 2) who received radiation and
chemotherapy for non—small cell carcinoma of lung. Registered CT
(blue) and PET (orange) data sets show that area of
increased FDG uptake correlates to area of volume loss and bronchiectasis in
right upper lobe from radiation fibrosis.
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Fig. 2A. —70-year-old man (patient 7) with history of lung and
esophageal carcinoma who had right pneumonectomy and esophagectomy. Coronal
(A) and axial (B) images of FDG positron emission tomography
(PET) scan show focal area of increased FDG uptake (arrows) in
posterior right thorax. This area of increased FDG uptake was interpreted as
recurrent disease on PET.
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Fig. 2B. —70-year-old man (patient 7) with history of lung and
esophageal carcinoma who had right pneumonectomy and esophagectomy. Coronal
(A) and axial (B) images of FDG positron emission tomography
(PET) scan show focal area of increased FDG uptake (arrows) in
posterior right thorax. This area of increased FDG uptake was interpreted as
recurrent disease on PET.
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Fig. 2C. —70-year-old man (patient 7) with history of lung and
esophageal carcinoma who had right pneumonectomy and esophagectomy.
Registration of CT (blue) and PET (orange) data sets shows
that area of increased FDG uptake corresponds to physiologic uptake at gastric
pull-through (arrow, C). Subsequent studies showed no evidence
of metastatic disease.
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Fig. 2D. —70-year-old man (patient 7) with history of lung and
esophageal carcinoma who had right pneumonectomy and esophagectomy.
Registration of CT (blue) and PET (orange) data sets shows
that area of increased FDG uptake corresponds to physiologic uptake at gastric
pull-through (arrow, C). Subsequent studies showed no evidence
of metastatic disease.
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Fig. 3A. —76-year-old man (patient 15) with non—small cell lung
carcinoma of right upper lobe. Coronal (A) and axial (B) images
of FDG positron emission tomography (PET) scan show increased FDG uptake
(arrows) in right upper lobe mass and mediastinum. Nodal metastases
were localized to right paratracheal and hilar regions on PET
interpretation.
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Fig. 3B. —76-year-old man (patient 15) with non—small cell lung
carcinoma of right upper lobe. Coronal (A) and axial (B) images
of FDG positron emission tomography (PET) scan show increased FDG uptake
(arrows) in right upper lobe mass and mediastinum. Nodal metastases
were localized to right paratracheal and hilar regions on PET
interpretation.
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Fig. 3C. —76-year-old man (patient 15) with non—small cell lung
carcinoma of right upper lobe. Registration of CT (blue) and PET
(orange) data sets localizes areas of increased FDG uptake to right
paratracheal (arrow, C) and subcarinal (arrow,
D) regions.
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Fig. 3D. —76-year-old man (patient 15) with non—small cell lung
carcinoma of right upper lobe. Registration of CT (blue) and PET
(orange) data sets localizes areas of increased FDG uptake to right
paratracheal (arrow, C) and subcarinal (arrow,
D) regions.
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Fig. 4A. —70-year-old woman (patient 3) who received radiation and
chemotherapy for recurrent lung cancer. FDG positron emission tomography (PET)
scan shows area of increased FDG uptake (arrow) in left thorax, which
was interpreted as possible tumor or radiation changes. Location of uptake
could not be specified despite visual correlation with CT scan.
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Fig. 4B. —70-year-old woman (patient 3) who received radiation and
chemotherapy for recurrent lung cancer. Registration of CT (blue) and
PET localizes area of increased FDG uptake (arrow) in left thorax to
region of pericardial thickening consistent with pericardial metastasis.
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Fig. 4C. —70-year-old woman (patient 3) who received radiation and
chemotherapy for recurrent lung cancer. Follow-up CT scan 4 months after
A and B shows large pericardial effusion (arrows),
which was malignant on cytologic evaluation.
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Copyright © 2002 by the American Roentgen Ray Society.
