title: Early lung cancer detection using spiral computed tomography and positron emission tomography.
abstract: BACKGROUND
  Lung cancer screening using computed tomography (CT) is effective in detecting lung cancer in early stages. Concerns regarding false-positive rates and unnecessary invasive procedures have been raised.
  
  
  OBJECTIVE
  To study the efficiency of a lung cancer protocol using spiral CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET).
  
  
  METHODS
  High-risk individuals underwent screening with annual spiral CTs. Follow-up CTs were done for noncalcified nodules of 5 mm or greater, and FDG-PET was done for nodules 10 mm or larger or smaller (> 7 mm), growing nodules.
  
  
  RESULTS
  A total of 911 individuals completed a baseline CT study and 424 had at least one annual follow-up study. Of the former, 14% had noncalcified nodules of 5 mm or larger, and 3.6% had nodules of 10 mm or larger. Eleven non-small cell lung cancers (NSCLC) and one small cell lung cancer (SCLC) were diagnosed in the baseline study (prevalence rate, 1.32%), and two NSCLCs in the annual study (incidence rate, 0.47%). All NSCLCs (92% of prevalence cancers) were diagnosed in stage I (12 stage IA, 1 stage IB). FDG-PET was helpful for the correct diagnosis in 19 of 25 indeterminate nodules. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET for the diagnosis of malignancy were 69, 91, 90, and 71%, respectively. However, the sensitivity and negative predictive value of the screening algorithm, which included a 3-month follow-up CT for nodules with a negative FDG-PET, was 100%.
  
  
  CONCLUSIONS
  A protocol for early lung cancer detection using spiral CT and FDG-PET is useful and may minimize unnecessary invasive procedures for benign lesions.
authors.affiliation: Department of Radiology, Clínica Universitaria, Avda. Pio XII, 36, 31008 Pamplona, Spain.
authors.forename: Gorka
authors.initials: G
authors.lastname: Bastarrika
authors.forename: María José
authors.initials: MJ
authors.lastname: García-Velloso
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Lozano
authors.forename: Usua
authors.initials: U
authors.lastname: Montes
authors.forename: Wenceslao
authors.initials: W
authors.lastname: Torre
authors.forename: Natalia
authors.initials: N
authors.lastname: Spiteri
authors.forename: Arantza
authors.initials: A
authors.lastname: Campo
authors.forename: Luis
authors.initials: L
authors.lastname: Seijo
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Alcaide
authors.forename: Jesús
authors.initials: J
authors.lastname: Pueyo
authors.forename: David
authors.initials: D
authors.lastname: Cano
authors.forename: Isabel
authors.initials: I
authors.lastname: Vivas
authors.forename: Octavio
authors.initials: O
authors.lastname: Cosín
authors.forename: Pablo
authors.initials: P
authors.lastname: Domínguez
authors.forename: Patricia
authors.initials: P
authors.lastname: Serra
authors.forename: José A
authors.initials: JA
authors.lastname: Richter
authors.forename: Luis
authors.initials: L
authors.lastname: Montuenga
authors.forename: Javier J
authors.initials: JJ
authors.lastname: Zulueta
mesh_terms: D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D015995:Prevalence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects*; D013030:Spain / Q000453:epidemiology; D013147:Spirometry; D036542:Tomography, Spiral Computed / Q000379:methods*
chemical_list: D019788:Fluorodeoxyglucose F18