Contrast computed tomography versus PET/CT in the assessment of bronchogenic carcinoma

Background In the past decades, diagnostic imaging modalities of bronchogenic carcinoma were chest radiography and computed tomography (CT) to determine the tumor size and mediastinal lymph nodes involved, as well as liver and adrenal metastases. Now PET/CT has become a routine procedure for the primary assessment (initial staging) in the detection of functional tumor activity (viable cells). Objective The objective of this study was to compare between contrast CT and PET/CT in the assessment of bronchogenic carcinoma (initial staging) and impact of weight and BMI on it. Patients and methods This was a cross-sectional study that involved 100 patients for initial staging of newly diagnosed bronchogenic carcinoma examined by contrast CT and PET/CT. In addition to anthropometry measures, weight and height were taken and BMI was calculated. Results The initial staging of bronchogenic carcinoma showed significant differences between PET/CT versus contrast CT (P=0.001). Upstaging done by PET/CT in six patients (stages I and II), as well as an agreement between CT and PET/CT in stage III and IV was detected. The evaluation showed a sensitivity and specificity of 75.2-89.4% and 78.2-90.0% for CT and 97.2-100% and 98.5-100% for PET/CT, respectively. There is a significant positive correlation between tumor size and its metabolic activity measured by the maximum standardized uptake value. However, there was no significant correlation between BMI and maximum standardized uptake value; moreover not any significant association between BMI and metastatic deposits was detected. Conclusion PET/CT is a powerful imaging modality for the assessment of functional behavior of tumor cells to avoid false results depending on the morphology only as contrast CT, which leads to change the decision taken for the management of bronchogenic carcinomas.