Integrated FDG-PET/CT vs. standard radiological examinations: comparison of capability for assessment of postoperative recurrence in non-small cell lung cancer patients.
OBJECTIVE
The purpose of this study was to prospectively and directly compare diagnostic capabilities of whole-body integrated FDG-PET/CT and standard radiologic examination for assessment of recurrence in postoperative non-small cell lung cancer (NSCLC) patients.


METHODS
A total of 92 consecutive pathologically diagnosed NSCLC patients (65 males, 27 females; mean age, 71 years) underwent pathologically and surgically proven complete resection, followed by prospective whole-body FDG-PET/CT and standard radiological examinations. Final diagnosis of recurrence was based on the results of more than 1 year of follow-up and/or pathological examinations. On both methods, the probability of recurrence was assessed in each patient by using a five-point visual scoring system, and the each final diagnosis was made by consensus between two readers. Kappa analyses were performed to determine inter-observer agreement for both methods, and ROC analyses were used to compare capability of the two methods for assessment of postoperative recurrence on a per-patient basis. Sensitivity, specificity and accuracy were also compared between PET/CT and standard radiological examination by means of McNemar's test.


RESULTS
All inter-observer agreements were almost perfect (integrated PET/CT: kappa=0.89; standard radiological examination: kappa=0.81). There were no statistically significant differences in area under the curve, sensitivity, specificity and accuracy between integrated FDG-PET/CT and standard radiologic examinations (p>0.05).


CONCLUSIONS
Integrated FDG-PET/CT can be used for assessment of postoperative recurrence in NSCLC patients with accuracy as good as that of standard radiological examinations.
Takenaka
Daisuke
D
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
Ohno
Yoshiharu
Y
Koyama
Hisanobu
H
Nogami
Munenobu
M
Onishi
Yumiko
Y
Matsumoto
Keiko
K
Matsumoto
Sumiaki
S
Yoshikawa
Takeshi
T
Sugimura
Kazuro
K
D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D013382:Subtraction Technique; D018511:Systems Integration; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014962:X-Ray Film
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18