title: 18F-FDG PET/Contrast-Enhanced CT for Initial Staging and Strategic Treatment of Non-Small Cell Lung Cancer: A Prospective Study.
abstract: BACKGROUND
  Selection of the best treatment option for non-small cell lung cancer (NSCLC) depends on optimal initial staging.
  
  
  OBJECTIVE
  Evaluate the clinical impact of 18F-FDG PET/CT on the management of Thai patients with NSCLC.
  
  
  METHODS
  Twenty-four patients with NSCLC underwent FDG PET/CTfor initial staging. The best treatment options between pre- and post-FDG PET/CT staging were identified for each patient. Changes in treatment management decisions and the diagnostic values (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) of nodal and distant metastases were assessed.
  
  
  RESULTS
  Pre-FDG PET/CT staging included five patients with stage IA, four patients with stage IB, one patient with stage IIB, three patients with stage IIIA, and 11 patients with stage IV disease. A difference between pre- and post-FDG PET/CT staging was noted in 10/24 patients (41.7%). FDG PET/CT examination resulted in upstaging in 7/24 patients (29%) and downstaging in three patients (12.5%). The pre-FDG PET/CT staging was accurate in 14/24 patients (58.3%) while the post-FDG PET/CTstaging was accurate in 19/24 patients (79.2%). The treatment management decisions were changed in 5/24 patients (20.8%). FDG PET/CT prevented futile surgery in two patients.
  
  
  CONCLUSIONS
  FDG PET/CT has an important role in NSCLC staging. Additional PET/CT information could influence therapeutic options and reduced unnecessary surgery in patients with metastatic disease.
authors.forename: Chetsadaporn
authors.initials: C
authors.lastname: Promteangtrong
authors.forename: Anchisa
authors.initials: A
authors.lastname: Kunawudhi
authors.forename: Rossarin
authors.initials: R
authors.lastname: Phadungrerk
authors.forename: Chanidapa
authors.initials: C
authors.lastname: Iamsa-art
authors.forename: Chanisa
authors.initials: C
authors.lastname: Chotipanich
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18