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The Utility of ¹⁸F-FDG PET for Suspected Recurrent Non–Small Cell Lung Cancer After Potentially Curative Therapy: Impact on Management and Prognostic Stratification

Department of Diagnostic Imaging, Pratt Foundation Statistical Centre, and Division of Radiation Oncology, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia

View larger version (91K): [in a new window]   FIGURE 1. Hemoptysis and residual mass 9 mo after radical chemoradiotherapy for left upper lobe NSCLC suggested local relapse despite partial CT response between baseline (A) and posttreatment (B) scans. Representative transaxial (C), sagittal (D), and coronal (E) planes of PET scan showed low-grade pleural changes consistent with postradiotherapy effects but no evidence of recurrent disease. Palliative radiotherapy was cancelled, and patient remained well >12 mo after PET without evidence of active disease.

View larger version (12K): [in a new window]   FIGURE 2. Graph shows strong prognostic stratification by whether PET was positive or negative for relapse in 63 consecutive patients in whom relapse was suspected on basis of conventional imaging findings (n = 61) or clinical features (n = 2).

View larger version (16K): [in a new window]   FIGURE 3. Graph shows strong relationship between apparent extent of disease on PET scanning and survival in 63 consecutive patients in whom relapse was suspected on basis of conventional evaluation. This relationship remained significant after adjusting for pre-PET evaluation of extent of disease relapse or for treatment subsequently delivered. ENR = extensive nodal relapse; LNR = limited nodal relapse; LR = local relapse; SR = systemic relapse.