[Evaluation of efficacy and clinical impact of FDG-PET on patients with potentially resectable non-small cell lung cancer].
OBJECTIVE
We have evaluated the efficacy and clinical impact of FDG-PET for staging patients with potentially resectable non-small cell lung cancer (NSCL) in CT.


METHODS
We have prospectively studied 115 patients (104 M/11 F and mean age: 59 years old) with diagnosis of potentially resectable NSCL, (resectable criteria: Stage <IIIB in CT), including cases with equivocal lesions in mediastinum or in extrathoracic sites. In all patients we have done a whole body scan with FDG-PET, after intravenous injection of 370-440 MBq of 18F-FDG, in normoglucemia conditions. A qualitative and semiquantitative (SUV) analysis of images was carried out.


RESULTS
Prevalence of mediastine lymphatic metastasis was 46.6 %, and CT was false negative (FN) in 21 cases and FDG-PET only in 9. Overall sensitivity, specificity, negative predictive value, positive predictive value and accuracy were of 83.3, 73.7, 75, 81.8 % and 78.3 % in FDG-PET, and 61.1, 68.8, 64.7, 65.6 % and 65.2 % in CT, respectively. All contralateral or supraclavicular lymph metastasis (N3) were detected in FDG-PET, whereas CT had 7 FN cases. In distant metastasis, FDG-PET had 1 FN and 4 FP, whereas CT had 6 cases FN and 10 FP. Clinical Impact of FDG-PET was 26 % of patients, avoiding surgery in 11 cases, allowing in 8, indicating neoadjuvant chemotherapy in 8 and surgery of synchronic incidentaloma in 3 cases.


CONCLUSIONS
PET-FDG had better efficacy than CT in resectable NSCL, and should be incorporated in diagnosis protocols of NSCL before surgery decision making.
Borrego Dorado
I
I
Unidad de Diagnóstico de Medicina Nuclear. Hospital Universitario Virgen del Rocío. Sevilla. España. isabel.borrego.sspa@juntadeandalucia.es
López García
C
C
Vázquez Albertino
R
R
Ginel Cañamaque
A
A
Barrot Cortés
E
E
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18