title: Long-Term Follow-Up Results From PET/CT Surveillance After Surgical Resection of Lung Adenocarcinoma Manifesting as Ground-Glass Opacity.
abstract: The purpose of our study was to retrospectively evaluate the value of F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for postoperative surveillance of lung adenocarcinoma manifesting as ground-glass opacity (GGO).From May 2003 to December 2007, 111 patients with surgically resected lung adenocarcinoma manifesting as GGO were included. Clinical findings of recurrence and survival, CT features, and maximum standardized uptake value (SUVmax) were reviewed and compared among 3 groups according to GGO proportion: Group I, GGO 100%; Group II, GGO ≥50%; Group III, GGO < 50%. Disease-free survival (DFS) was estimated using the Kaplan-Meier method. Diagnostic performances of CT and PET/CT for recurrence were compared during a long-term follow-up period of >5 years.Recurrence was identified in Group III (18 of 53, 34%) but not in Groups I (n = 25) or II (n = 33) over a mean follow-up period of 74 months. Group showed significant differences in GGO proportion, SUVmax, and DFS duration (P < 0.001). PET/CT led to 6 false-positive and 5 false-negative interpretations of recurrence. For surveillance CT, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 94.4%, 98.6%, 98.2%, 94.4%, and 98.9%, respectively; for PET/CT, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 72.2%, 92.3%, 88.5%, 68.4%, and 93.5%, respectively. CT showed significantly higher accuracy than PET/CT (P = 0.0188).FDG-PET/CT showed no clear advantage for postoperative surveillance of lung cancer with predominant GGO because of low incidence of recurrence and frequent false-positive and false-negative results.
authors.affiliation: From the Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si (KBN, TJK, KWL); and Department of Biochemistry, College of Medicine, Dankook University, Cheonan, Korea (J-SP).
authors.forename: Kyung Bum
authors.initials: KB
authors.lastname: Nam
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Kim
authors.forename: Jeong-Soo
authors.initials: JS
authors.lastname: Park
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Chung
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
references.citation: J Thorac Cardiovasc Surg. 2004 Mar;127(3):857-61
references.pmid: 15001917
references.citation: Eur J Nucl Med Mol Imaging. 2006 Jan;33(1):13-21
references.pmid: 16151765
references.citation: AJR Am J Roentgenol. 2012 Jan;198(1):83-8
references.pmid: 22194482
references.citation: J Thorac Cardiovasc Surg. 2005 Jun;129(6):1226-31
references.pmid: 15942561
references.citation: Medicine (Baltimore). 2015 Jan;94(3):e434
references.pmid: 25621697
references.citation: Cancer. 2009 Nov 15;115(22):5218-27
references.pmid: 19672942
references.citation: J Thorac Oncol. 2012 Aug;7(8):1263-70
references.pmid: 22673056
references.citation: Am J Nucl Med Mol Imaging. 2013 Sep 19;3(5):408-16
references.pmid: 24116349
references.citation: Br J Radiol. 2008 Oct;81(970):821-5
references.pmid: 18796557
references.citation: Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):859-64
references.pmid: 22914804
references.citation: Radiology. 2013 Jul;268(1):254-64
references.pmid: 23468578
references.citation: J Thorac Cardiovasc Surg. 2010 Jun;139(6):1447-51
references.pmid: 20005529
references.citation: Lung Cancer. 2007 Jun;56(3):341-8
references.pmid: 17350137
references.citation: J Thorac Oncol. 2009 Nov;4(11):1331-6
references.pmid: 19701106
references.citation: Radiology. 2014 Feb;270(2):574-82
references.pmid: 24086072
references.citation: Radiology. 2001 Sep;220(3):803-9
references.pmid: 11526285
references.citation: Eur J Nucl Med Mol Imaging. 2009 Nov;36(11):1794-802
references.pmid: 19430783
references.citation: J Thorac Oncol. 2007 Jan;2(1):29-33
references.pmid: 17410006
references.citation: Pneumonol Alergol Pol. 2013;81(3):214-20
references.pmid: 23609428
references.citation: Radiology. 2013 Jan;266(1):62-71
references.pmid: 23070271
references.citation: Chest. 2010 May;137(5):1150-6
references.pmid: 20038738
references.citation: Ann Thorac Surg. 2011 Nov;92(5):1826-32; discussion 1832
references.pmid: 22051278
references.citation: J Thorac Oncol. 2007 Apr;2(4):273-81
references.pmid: 17409797
references.citation: Radiology. 2008 Mar;246(3):697-722
references.pmid: 18195376
references.citation: J Thorac Cardiovasc Surg. 1975 Oct;70(4):606-12
references.pmid: 170482
references.citation: Eur J Radiol. 2012 Nov;81(11):3518-23
references.pmid: 22436434
references.citation: Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3
references.pmid: 7677489
references.citation: Chest. 2013 May;143(5 Suppl):e437S-e454S
references.pmid: 23649451
references.citation: Radiol Clin North Am. 2014 Jan;52(1):17-25
references.pmid: 24267708
references.citation: Eur Radiol. 2012 Jul;22(7):1556-63
references.pmid: 22358427
references.citation: J Thorac Cardiovasc Surg. 2002 Aug;124(2):278-84
references.pmid: 12167787
references.citation: CA Cancer J Clin. 2015 Mar;65(2):87-108
references.pmid: 25651787