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Ann Thorac Surg 2005;80:2020-2025
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

¹¹C-Acetate Positron Emission Tomography Imaging for Lung Adenocarcinoma 1 to 3 cm in Size With Ground-Glass Opacity Images on Computed Tomography

^a Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University
^b Department of Thoracic Surgery, Saiseikai Central Hospital
^c Development in Assistive Diagnostic Technology, National Cancer Center Hospital
^d Nishidai Clinic, Tokyo, Japan

Accepted for publication June 3, 2005.

^_* Address correspondence to Dr Nomori, Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan (Email: hnomori{at}qk9.so-net.ne.jp).

BACKGROUND: Positron-emission tomography (PET) with ¹⁸F-fluorodeoxy-glucose (FDG) frequently gives false-negative results for well-differentiated adenocarcinomas of the lung, especially, those with ground-glass opacity images. Recently, PET with ¹¹C-acetate (AC) has been reported to detect slow-growing tumors that have failed to be identified by FDG-PET, such as well-differentiated hepatocellular carcinomas and prostate cancers. To determine the usefulness of AC-PET in detecting well-differentiated adenocarcinomas of the lung, we performed both AC-PET and FDG-PET on pulmonary nodules with ground-glass opacity images on computed tomography (CT).

METHODS: Fifty-four pulmonary nodules 1 to 3 cm in size, which showed ground-glass opacity images over their whole or peripheral area on CT, were examined by both AC-PET and FDG-PET.

RESULTS: Thirty-seven nodules were adenocarcinoma of the lung, while 17 were inflammatory. Of the 37 adenocarcinomas, 19 (51%) were positively identified by AC-PET and 14 (38%) by FDG-PET. Of the 23 adenocarcinomas which were not identified by FDG-PET, 8 (35%) were positively identified by AC-PET; all were well-differentiated adenocarcinomas. Of the 17 inflammatory nodules, 8 were chronic and 9 were acute ones. While none of the 8 chronic inflammatory nodules were identified by either technique, 9 acute ones showed a variety of the results with AC- and FDG-PET.

CONCLUSIONS: AC-PET detected approximately one third of well-differentiated adenocarcinomas of the lung which were not identified by FDG-PET. AC-PET could be useful to diagnose pulmonary nodules with ground-glass opacity images which were not identified by FDG-PET.

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