Document Detail


PET/CT using 18F-FDG in suspected lung cancer recurrence: diagnostic value and impact on patient management.
MedLine Citation:
PMID:  15471827     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The goal of this study was to assess the value of hybrid imaging using a combined PET/CT device with 18F-FDG in the diagnosis and clinical management of suspected recurrent lung cancer. METHODS: Forty-two patients with non-small cell lung cancer (NSCLC) with suspected recurrence due to new clinical, biochemical, and radiologic findings were prospectively evaluated. PET/CT results were compared with PET interpreted with side-by-side CT data. A final diagnosis of recurrence was confirmed by histologic tissue sampling during surgery or biopsy or by further clinical and radiologic work-up. The impact of PET/CT on patient management was assessed. RESULTS: Twenty-four of 27 positive PET/CT studies (89%) were proven to have recurrent disease. Fourteen of 15 negative PET/CT studies (93%) had no evidence of disease. The sensitivity, specificity, and positive and negative predictive values of PET/CT for diagnosis of recurrence were 96%, 82%, 89%, and 93% compared with 96%, 53%, 75%, and 90%, respectively, for PET. PET/CT changed the PET lesion classification in 22 patients (52%), by determining the precise localization of sites of increased 18F-FDG uptake. PET/CT changed the management of 12 patients (29%) by eliminating previously planned diagnostic procedures (5 patients), by initiating a previously unplanned treatment option (4 patients), or by inducing a change in the planned therapeutic approach (3 patients). CONCLUSION: In patients with a suspected recurrence of NSCLC, PET/CT provides a better anatomic localization of suspicious lesions compared with PET interpreted with side-by-side CT data. This improved diagnostic performance of PET/CT has a further impact on the clinical management and treatment planning of the patients.
Authors:
Zohar Keidar; Nissim Haim; Luda Guralnik; Mirjana Wollner; Rachel Bar-Shalom; Alon Ben-Nun; Ora Israel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  45     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-08     Completed Date:  2004-12-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1640-6     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel. zohar@keidar.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / radiography,  radionuclide imaging,  therapy
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Lung Neoplasms / radiography*,  radionuclide imaging*,  therapy
Male
Middle Aged
Neoplasm Recurrence, Local / radiography*,  radionuclide imaging*,  therapy
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique
Tomography, X-Ray Computed / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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