When using combined PET/CT, adopting a true whole-body field-of-view to image cancer patients could lead to more accurate staging and restaging than a routine, limited whole-body field-of-view, according to a study in the December issue of the American Journal of Roentgenology.
The study, conducted at Saint Louis University in Missouri, enrolled 500 patients who underwent true whole-body FDG-PET/CT, from the top of the skull to the bottom of the feet. Of those 500 patients, 59 had PET/CT findings that suggested malignancy outside the limited whole-body field-of-view. New cancerous involvement was confirmed in 20 of the 59 patients.
The detection of malignancy outside the limited whole-body field-of-view resulted in a change in management in 65% of the 20 cases and a change in staging in 55%.
Lead study author Medhat Osman, MD, PhD, noted that the use of the routine field-of-view for whole-body FDG-PET/CT can lead to underestimation of the true extent of the disease, because metastasis outside the typical base of skull to upper thigh field-of-view can be missed.
The results "show that compared with limited whole-body acquisition, use of true whole-body image acquisition may increase the accuracy of staging, change the treatment of cancer patients, and help in the selection of more accessible biopsy sites, avoiding unnecessary invasive surgical procedures and eliminating unnecessary imaging," Osman and colleagues wrote.
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