Non-small cell carcinoma: comparison of postoperative intra- and extrathoracic recurrence assessment capability of qualitatively and/or quantitatively assessed FDG-PET/CT and standard radiological examinations.
OBJECTIVE
The purpose of this study was to compare the capability of integrated FDG-PET/CT for assessment of postoperative intra- and extrathoracic recurrence in non-small cell lung cancer (NSCLC) patients with that of standard radiological examinations.


METHODS
A total of 121 consecutive pathologically diagnosed NSCLC patients (80 males, 41 females; mean age, 71 years) underwent pathologically and surgically confirmed complete resection, followed by prospective integrated FDG-PET/CT and standard radiological examinations. Final diagnosis of recurrence was based on the results of more than 12 months of follow-up and/or pathological examinations. The probability of recurrence was assessed with either method for each patient by using 5-point visual scoring system, and final diagnosis was made by consensus between two readers. ROC analysis was used to compare the capability of the two methods for assessment of postoperative recurrence on a per-patient basis. The ROC-based positive test was used to determine optimal cut-off value for FDG uptake measurement at a site suspected on the basis of qualitatively assessed PET/CT. Finally, sensitivities, specificities and accuracies of all methods were compared by means of McNemar's test.


RESULTS
Areas under the curve of qualitatively assessed PET/CT and standard radiological examinations showed no significant differences (p>0.05). At an optimal cut-off value of 2.5, specificity and accuracy of quantitatively and qualitatively assessed PET/CT were significantly higher than those of qualitatively assessed PET/CT and standard radiological examinations (p<0.05).


CONCLUSIONS
Accuracy of assessment of postoperative intra- and extrathoracic recurrence in NSCLC patients by qualitative and/or quantitative FDG-PET/CT is equivalent to or higher than that by standard radiological examinations.
Onishi
Yumiko
Y
Department of Radiology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe 650-0017, Hyogo, Japan. onitan@med.kobe-u.ac.jp
Ohno
Yoshiharu
Y
Koyama
Hisanobu
H
Nogami
Munenobu
M
Takenaka
Daisuke
D
Matsumoto
Keiko
K
Yoshikawa
Takeshi
T
Matsumoto
Sumiaki
S
Maniwa
Yoshimasa
Y
Nishimura
Yoshihiro
Y
Sugimura
Kazuro
K
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18