Coincidence detection FDG PET in the management of oncological patients: attenuation correction versus non-attenuation correction

Nucl Med Commun. 2001 Nov;22(11):1185-92. doi: 10.1097/00006231-200111000-00004.


The aim of this study was to determine if attenuation correction (AC) in a dual-head, coincidence, positron emission tomography imaging system (Co-PET) improved image quality, lesion detection, patient staging and management of various malignant neoplasms, compared to non-attenuation corrected (NAC) images. Thirty patients with known or suspected malignant neoplasms underwent fluorodeoxyglucose (FDG) Co-PET, which was correlated with histopathology, computed tomography (CT) and other conventional imaging modalities and clinical follow-up. The number and location of FDG avid lesions detected on the AC images and NAC Co-PET images were blindly assessed by two independent observers. Semi-quantitative grading of image clarity and lesion-to-background quality was performed. This revealed markedly improved image clarity and lesion-to-background quality in the AC versus NAC Co-PET images. AC Co-PET was statistically superior to NAC Co-PET in relation to lesion detection (P<0.01) and tumour staging (P<0.01). NAC Co-PET demonstrated 51 of the 65 lesions (78%) detected by AC Co-PET. AC Co-PET altered tumour staging in five additional patients (16%) compared to NAC Co-PET. Management was altered in two of these five patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Gamma Cameras
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / pathology
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms / diagnostic imaging*
  • Neoplasms / pathology
  • Radiopharmaceuticals*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thoracic Neoplasms / diagnostic imaging
  • Thoracic Neoplasms / pathology
  • Tomography, Emission-Computed / instrumentation
  • Tomography, Emission-Computed / methods
  • Tomography, X-Ray Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18