title: FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.
abstract: OBJECTIVE
  This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax.
  
  
  METHODS
  FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated.
  
  
  RESULTS
  The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients.
  
  
  CONCLUSIONS
  High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.
authors.affiliation: Department of Nuclear Medicine, Dr. Bernard Verbeeten Institute, Tilburg, The Netherlands.
authors.forename: Anne I J
authors.identifier: http://orcid.org/0000-0001-7066-5372
authors.initials: AI
authors.lastname: Arens
authors.affiliation: Department of Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Jan W A
authors.initials: JW
authors.lastname: Postema
authors.affiliation: Department of Nuclear Medicine, Atrium Medical Centre, Heerlen, The Netherlands.
authors.forename: Wendy M J
authors.initials: WM
authors.lastname: Schreurs
authors.affiliation: Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Lafeber
authors.affiliation: Department of Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Baudewijn W
authors.initials: BW
authors.lastname: Hendrickx
authors.affiliation: Department of Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Wim J G
authors.initials: WJ
authors.lastname: Oyen
authors.affiliation: Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Wouter V
authors.initials: WV
authors.lastname: Vogel
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D013909:Thorax / Q000473:pathology*
chemical_list: D019788:Fluorodeoxyglucose F18