| The clinical impact of integrated FDG PET-CT on management decisions in patients with lung cancer. | |
| | |
MedLine Citation:
|
PMID: 19004519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: To retrospectively evaluate the clinical impact of FDG PET-CT on the management pathway of patients with lung cancer. PATIENTS AND METHODS: One hundred and sixty-one patients with suspected lung cancer undergoing FDG PET-CT during the study period were analyzed. Before PET-CT, lung cancer MDT recorded scan indication, conventional clinical stage, and proposed treatment plan. The accuracy of integrated PET-CT compared with stand alone CT in preoperative staging of lung cancer was evaluated with pathological staging used as the reference standard. The effect of PET-CT on the subsequent management of patients was also evaluated. RESULTS: The agreement between CT and integrated PET-CT in preoperative staging of lung cancer was significant (p<0.001). In 16 (10%) patients PET-CT excluded tumour as there was no FDG uptake. PET-CT revealed occult metastasis in 25 (16%) patients. It was also a better overall predictor for T status (64% vs. 58%) and N status (78% vs. 65%). For N staging PET-CT was more accurate for N1 (82% vs. 72%) and N2 (85% vs. 80%) disease. Regression analyses suggested that PET-CT was a better predictor of overall TNM staging for lung cancer. FDG PET scanning changed or influenced management decisions in 66 (41%) patients with lung cancer. Changes in TNM staging following PET-CT were significant predictors (p=0.02) in making a decision to abandon thoracotomies. CONCLUSION: Addition of PET-CT to comprehensive evaluation of lung cancer can have significant clinical impact. There is marked improvement in staging the disease. Patients were frequently spared unnecessary treatment, and management was more appropriately targeted. PET permits reduction in the number of thoracotomies performed for non-resectable disease with predicted reduction in the morbidity rate and cost associated with unnecessary interventions. |
| | |
Authors:
|
N Subedi; A Scarsbrook; M Darby; K Korde; P Mc Shane; M F Muers |
Related Documents
:
|
9257149 - Preoperative and postoperative imaging for colorectal cancer. 16474909 - Utility of preoperative [(18)]f fluorodeoxyglucose-positron emission tomography scannin... 12417599 - Evaluation of esophageal cancer by positron emission tomography. 18284629 - Pet/ct in the management of haematological malignancies. 11973489 - Reproducibility and clinical value of 18f-fluorodeoxyglucose positron emission tomograp... 22283139 - Dynamic gadolinium-enhanced magnetic resonance imaging allows accurate assessment of th... 10815659 - Mr imaging of cns involvement in children affected by chronic liver disease. 9345539 - Applications of dynamic susceptibility contrast magnetic resonance imaging in neuropsyc... 10820349 - Photodetection of cervical intraepithelial neoplasia using 5-aminolevulinic acid-induce... |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2008-11-11 |
Journal Detail:
|
Title: Lung cancer (Amsterdam, Netherlands) Volume: 64 ISSN: 1872-8332 ISO Abbreviation: Lung Cancer Publication Date: 2009 Jun |
Date Detail:
|
Created Date: 2009-05-05 Completed Date: 2009-07-09 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8800805 Medline TA: Lung Cancer Country: Ireland |
Other Details:
|
Languages: eng Pagination: 301-7 Citation Subset: IM |
Affiliation:
|
Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom. nrsubedi@yahoo.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Carcinoma, Bronchogenic / pathology, radionuclide imaging*, surgery Cost-Benefit Analysis Decision Support Techniques Female Humans Lung Neoplasms / pathology, radionuclide imaging*, surgery Male Middle Aged Neoplasm Staging* Patient Care Planning Positron-Emission Tomography Retrospective Studies Thoracotomy / economics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Quality management and patient safety: Survey results from 102 Hungarian hospitals.
Next Document: Outcomes with first-line platinum-based combination chemotherapy for malignant pleural mesothelioma:...