Document Detail


Evaluation of (18)F-FDG PET-CT for differentiation of pulmonary pathology in an approach of outpatient fast track assessment.
MedLine Citation:
PMID:  19687763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The aim of our study was to evaluate the clinical performance/ implementation of integrated F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) for differentiation of pulmonary pathology in an approach of outpatient fast track assessment. METHODS: A prospective study was performed in 114 consecutive patients with pulmonary symptoms and/or abnormal chest x-ray were referred for fast track assessment to the Netherlands Cancer Institute from March 2005 to September 2007. The presence of malignancy was evaluated in a multidisciplinary setting, including F-fluorodeoxyglucose-PET, diagnostic CT, and bronchoscopy (including biopsy), with histopathological evaluation as the reference standard. RESULTS: In 105 patients (92%), a final diagnosis was achieved. A malignancy was diagnosed in 84% of the patients; non-small cell lung cancer in 67%, small cell lung cancer in 7%, and metastases or other malignancies in 10%. Nonmalignant lesions were found in 16% of the patients. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of positive PET/CT for the presence of malignancy were 97, 56, 90, 92, and 77%, respectively. PET/CT showed unexpected M1 disease (not detected on CT) in 10% of the patients. Almost half of the patients with a malignancy were scheduled for curative treatment, of whom 29 patients for surgery and 14 patients for chemoradiotherapy. CONCLUSION: In this outpatient fast track setting, PET/CT provides valuable information for diagnosing lung cancer, with a high positive predictive value, and is useful for clinical decision making.
Authors:
Tjeerd S Aukema; Renato A Vald?s Olmos; Houke M Klomp; Hendrik J Teertstra; Jos? S A Belderbos; Wouter V Vogel; Paul Baas; Sjaak A Burgers; Michel M van den Heuvel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  4     ISSN:  1556-1380     ISO Abbreviation:  J Thorac Oncol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2010-03-04     Completed Date:  2010-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1226-30     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. t.aukema@nki.nl
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Non-Small-Cell Lung / pathology,  radiography,  radionuclide imaging
Diagnosis, Differential
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Lung Neoplasms / pathology,  radiography*,  radionuclide imaging*
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Positron-Emission Tomography*
Prognosis
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Small Cell Lung Carcinoma / pathology,  radionuclide imaging,  therapy
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
J Thorac Oncol. 2009 Oct;4(10):1192-4   [PMID:  20197732 ]

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