Impact of whole-body ¹⁸F-fluorodeoxyglucose positron emission tomography on therapeutic management of non-small cell lung cancer.
OBJECTIVE
Accurate staging at the time of diagnosis is very important in deciding on the appropriate treatment for cancer patients. FDG PET indicates metabolic changes in cancer cells, enabling the early detection of lesions. This has the advantage of allowing more accurate staging than is possible with conventional staging tools, and has led to the incorporation of FDG PET in the initial work-up protocols for lung cancer patients. In this study, we evaluated the clinical impact of FDG PET as an initial staging tool, on the therapeutic management of patients with non-small cell lung cancer (NSCLC).


METHODS
Patients diagnosed with NSCLC by histopathology were retrospectively identified and both chest CT and FDG PET were performed for initial staging. Information was collected regarding the results of conventional versus FDG PET staging, and any resulting modifications of treatment were evaluated.


RESULTS
Among the 537 patients who were evaluated FDG PET resulted in upstaging of the tumour in 91 (17%) and downstaging of the tumour in 68 (13%). Consequently, therapeutic management was modified in 118 patients (22%). Furthermore, use of FDG PET resulted in the detection of a second primary cancer in six patients.


CONCLUSIONS
This study confirms that FDG PET has a considerable impact on the initial staging and therapeutic management of patients with NSCLC.
Heo
Eun Young
EY
Division of Pulmonary and Critical Care Medicine, Department of Medicine and Lung Institute, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea.
Yang
Seock-Chul
SC
Yoo
Chul-Gyu
CG
Han
Sung Koo
SK
Shim
Young-Soo
YS
Kim
Young Whan
YW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D051598:Whole Body Imaging / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18