27. PET Image Interpretation

Purpose: The purpose of this study was to evaluate the difference, if any, in lesion detection in ATN and NATN images.

Methods: Sixty-one consecutive patients having clinical whole body FDG PET scans for oncologic indications were included. The patients were administered 10-20 mCi FDG intravenously, and imaging on the Advance (GE Medical Systems) was started 45 min-1 h after injection. The emission images were acquired for 4 min and the transmission images for 3 min per bed position. The images were reviewed on the vendor-provided workstation. Four of the interpreting physicians read the ATN images first, and the other read the NATN images first. The interpreting physicians were asked to determine if any lesions were seen on only the ATN or NATN images (discordant findings) and to describe differences in the images not affecting overall interpretation.

Results: In the 61 patients, 3 discordant findings with abnormalities on the ATN images but not on the NATN images included the following: lung nodule, AP window node, and small para-aortic node. Observations that did not affect overall interpretation include the following: transmission scan helped localize lesion to be below instead of above the diaphragm; AT-N image better demonstrated liver metastasis; benign lung lesion seen only on ATN image (3 cases); pretracheal node seen better on NATN images; and low grade hilar activity on NATN not seen on ATN images.

Conclusion: These results demonstrate that the ATN images detect more lesions than the NATN images, and that reviewing NATN images may not be necessary. A different method for performing this evaluation is now being undertaken.