Clinical consequences after the introduction of PET/CT in a thorax surgery center: A one-year experience

Objectives In NSCLC, therapeutic decisions are strongly influenced by tumor stage. With the routine implementation of PET/CT in the diagnostic procedure, an improvement of accuracy in staging of NSCLC should be expected. In this study, we evaluate the efficacy of PET/CT in the initial staging of NSCLC and the consecutive change in therapeutic procedures.

Methods Since 2/2008 more than 500 pts with tumor diseases, predominantly with lung involvement, have been investigated with an integrated PET/CT scanner (Siemens Biograph 16). In a prospective manner, 127 patients were staged by FDG-PET/CT (60 min after 300 MBq F-18-FDG, contrast enhanced CT) before undergoing surgery and complete mediastinal lymphadenectomy. Data of 64 pts with NSCLC have been evaluated up to now: 37 men, 27 women; age 38-87 years. CT, PET and integrated PET/CT were reviewed by different specialists.

Results Histopathological results showed 59% adenoid, 38% squamous cell and 3% large cell carcinomas. The accuracy for the nodal involvement of CT and PET alone was 52% and 70% respectively, and of integrated PET/CT 83%. Extended lymph node involvement (N3) was detected in all cases by PET/CT (n=5). Due to the additional PET information, the stage based on CT was correctly changed in 32% (up in 6 and down staging in 15 pts).

Conclusions These data confirm FDG-PET/CT to be more accurate than contrast enhanced CT in staging of NSCLC patients and deserves becoming the new standard approach in the staging of these pts.

Research Support This study was supported by the Oskar-Helene-Heim Foundation, Berlin, Germany.