@article {Keidar1640, author = {Zohar Keidar and Nissim Haim and Luda Guralnik and Mirjana Wollner and Rachel Bar-Shalom and Alon Ben-Nun and Ora Israel}, title = {PET/CT Using 18F-FDG in Suspected Lung Cancer Recurrence: Diagnostic Value and Impact on Patient Management }, volume = {45}, number = {10}, pages = {1640--1646}, year = {2004}, publisher = {Society of Nuclear Medicine}, abstract = {The goal of this study was to assess the value of hybrid imaging using a combined PET/CT device with 18F-FDG in the diagnosis and clinical management of suspected recurrent lung cancer. Methods: Forty-two patients with non{\textendash}small cell lung cancer (NSCLC) with suspected recurrence due to new clinical, biochemical, and radiologic findings were prospectively evaluated. PET/CT results were compared with PET interpreted with side-by-side CT data. A final diagnosis of recurrence was confirmed by histologic tissue sampling during surgery or biopsy or by further clinical and radiologic work-up. The impact of PET/CT on patient management was assessed. Results: Twenty-four of 27 positive PET/CT studies (89\%) were proven to have recurrent disease. Fourteen of 15 negative PET/CT studies (93\%) had no evidence of disease. The sensitivity, specificity, and positive and negative predictive values of PET/CT for diagnosis of recurrence were 96\%, 82\%, 89\%, and 93\% compared with 96\%, 53\%, 75\%, and 90\%, respectively, for PET. PET/CT changed the PET lesion classification in 22 patients (52\%), by determining the precise localization of sites of increased 18F-FDG uptake. PET/CT changed the management of 12 patients (29\%) by eliminating previously planned diagnostic procedures (5 patients), by initiating a previously unplanned treatment option (4 patients), or by inducing a change in the planned therapeutic approach (3 patients). Conclusion: In patients with a suspected recurrence of NSCLC, PET/CT provides a better anatomic localization of suspicious lesions compared with PET interpreted with side-by-side CT data. This improved diagnostic performance of PET/CT has a further impact on the clinical management and treatment planning of the patients.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/45/10/1640}, eprint = {https://jnm.snmjournals.org/content/45/10/1640.full.pdf}, journal = {Journal of Nuclear Medicine} }