title: Integrated FDG-PET/CT vs. standard radiological examinations: comparison of capability for assessment of postoperative recurrence in non-small cell lung cancer patients.
abstract: 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.
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takenaka
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohno
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Koyama
authors.forename: Munenobu
authors.initials: M
authors.lastname: Nogami
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Onishi
authors.forename: Keiko
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Sumiaki
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18