Positron emission tomography with CT in the evaluation of non-small cell lung cancer in populations with a high prevalence of tuberculosis.
OBJECTIVE
To determine the utility of positron emission tomography with CT (PET-CT) in the evaluation of non-small cell lung cancer (NSCLC) in an Asian context where tuberculosis rates are moderately high.


METHODS
Case records of consecutive patients with NSCLC undergoing PET-CT at the Singapore General Hospital over a 1-year period were retrospectively reviewed. The authors evaluated the sensitivity and specificity of PET-CT at their institution using surgical pathology or the tincture of time as the gold standard.


RESULTS
A total of 54 patients underwent PET-CT during this period. Seven patients were evaluated for solitary pulmonary nodule, for which PET-CT gave a sensitivity of 100% and specificity of 75%. There was one patient with false positive PET-CT due to active tuberculosis. In total, 41 patients underwent PET-CT for staging of NSCLC. There was one false positive (patient was found to have active tuberculous lymphadenitis) and one false negative for NSCLC. This gave a sensitivity of 92.3% and a specificity of 95%. Histology from the adrenal glands was available in two patients with PET-CT that was positive for adrenal metastases. One proved to be benign whereas the other was consistent with metastasis. Two patients had PET-CT positive for liver metastases, which was verified by histology. Two patients with positive PET-CT for lesions in the colon turned out to be benign histologically.


CONCLUSIONS
Positron emission tomography with CT for the evaluation and follow-up of solitary pulmonary nodule and NSCLC can provide additional useful information to conventional radiology for treatment planning and a non-invasive determination of prognosis. However, physicians need to be aware of the limitations of this imaging modality, particularly when tuberculosis has a high prevalence in the population.
Low
Su-Ying
SY
Department of Respiratory and Critical Care Medicine, Singapore General Hospital. gm31sy@sgh.com.sg
Eng
Philip
P
Keng
Gilbert H W
GH
Ng
David C E
DC
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012846:Singapore; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000150:complications* / Q000473:pathology