PET-CT in the assessment of lung cancer at Rikshospitalet from 2007-2011.
BACKGROUND
PET-CT is an aid in the assessment of lung cancer for identifying operable patients. The examination is recommended for most patients with non-small cell lung cancer whom the primary assessment has indicated may have a curable disease. The aim was to assess the usefulness of PET-CT for patients assumed to be operable who underwent an examination at Rikshospitalet.


METHODS
Patients admitted for lung cancer assessment are registered consecutively in the department's quality database. We analysed data for the period 2007-2011 for patients whom a primary assessment had revealed to have a potentially operable tumour. For capacity reasons, some patients underwent surgery without a prior PET-CT.


RESULTS
Of 651 potentially operable patients, 533 had had a PET-CT scan of which 403 (76%) had undergone surgery. We calculated that the examination had a sensitivity of 78% (95% CI 70-86) and specificity 88% (95% CI 85-91%), positive predictive value 64% (95% CI 55-72) and negative predictive value 94% (95% CI 91-96) for spreading to mediastinal lymph nodes. Diagnostic accuracy was 86% (95% CI 83-89) with kappa agreement 0.61 (95% CI 0.53-0.69) between PET-CT and actual findings of malignant or benign mediastinal lymph nodes.


CONCLUSIONS
PET-CT was a useful tool for selecting potentially operable lung cancer patients at Rikshospitalet in the period 2007-2011. Provided that the population we scan with PET-CT does not change, patients with a negative PET-CT can with few exceptions be referred directly for surgery without further invasive assessment.
Thoraxkirurgisk avdeling Hjerte-, lunge- og karklinikken Oslo universitetssykehus, Rikshospitalet og Det medisinske fakultet Universitetet i Oslo.
Anders Standal
AS
Bugge
Lungeavdelingen Hjerte-, lunge- og karklinikken Oslo universitetssykehus, Rikshospitalet.
Anne
A
Naalsund
Avdeling for radiologi og nukleærmedisin Klinikk for diagnostikk og intervensjon Oslo universitetssykehus, Rikshospitalet og Det medisinske fakultet Universitetet i Oslo.
Kjersti
K
Johnsrud
Avdeling for radiologi og nukleærmedisin Klinikk for diagnostikk og intervensjon Oslo universitetssykehus, Rikshospitalet.
Audun Elnæs
AE
Berstad
Lungeavdelingen Hjerte-, lunge- og karklinikken Oslo universitetssykehus, Rikshospitalet og Det medisinske fakultet Universitetet i Oslo.
Johny
J
Kongerud
Lungeavdelingen Hjerte-, lunge- og karklinikken Oslo universitetssykehus, Rikshospitalet og Det medisinske fakultet Universitetet i Oslo.
May Brit
MB
Lund
D000368:Aged; D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods / Q000592:standards*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18