The utility of 99mTc depreotide compared with F-18 fluorodeoxyglucose positron emission tomography and surgical staging in patients with suspected non-small cell lung cancer.
OBJECTIVE
The findings from conventional imaging modalities, such as chest CT, are frequently unreliable in patients with lung cancer. This study was designed to compare the relative diagnostic accuracies and utility of the two most widely used functional imaging examinations, F-18-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and (99m)Tc depreotide scintigraphy, for the diagnosis and staging of lung cancer.


METHODS
Prospective, experimental investigation.


METHODS
Academic medical center.


METHODS
One hundred sixty-six subjects with suspected lung cancer were enrolled in the study.


METHODS
Whole-body and single-photon emission CT imaging of the chest was performed after IV administration of (99m)Tc depreotide. Attenuation-corrected FDG PET imaging was performed after IV administration of FDG. Image findings were compared with the biopsy results or clinical follow-up.


RESULTS
In 157 subjects with evaluable lung lesions, the sensitivities and specificities for detecting malignant disease (95% confidence intervals) of FDG PET are 96% (90 to 98%) and 71% (54 to 85%), and of (99m)Tc depreotide are 94% (88 to 98%) and 51% (34 to 68%). In the 139 subjects with available complete staging data, FDG PET correctly staged 76 of 139 patients (55%), and (99m)Tc depreotide correctly staged 63 of 139 patients (45%).


CONCLUSIONS
The sensitivity for detection of lung cancer in the primary lesion is equally high for FDG PET and (99m)Tc depreotide. The specificity is superior for FDG PET. The staging accuracy of FDG PET and (99m)Tc depreotide is similar, but when read with the chest CT neither scintigraphic examination is sufficiently accurate to stage patients with non-small cell lung cancer.
Kahn
Daniel
D
Nuclear Medicine Section 115, Iowa City VA Medical Center, Iowa City, IA 52246, USA. daniel-kahn@uiowa.edu
Menda
Yusuf
Y
Kernstine
Kemp
K
Bushnell
David
D
McLaughlin
Kelley
K
Miller
Sara
S
Berbaum
Kevin
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016284:Technetium Tc 99m Pentetate / Q000494:pharmacology*; D014055:Tomography, Emission-Computed / Q000379:methods*
D019788:Fluorodeoxyglucose F18; D016284:Technetium Tc 99m Pentetate