RT Journal Article
SR Electronic
T1 Effect of PET/CT on Management of Patients with Non–Small Cell Lung Cancer: Results of a Prospective Study with 5-Year Survival Data
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1007
OP 1015
DO 10.2967/jnumed.111.099713
VO 53
IS 7
A1 Deborah L. Gregory
A1 Rodney J. Hicks
A1 Annette Hogg
A1 David S. Binns
A1 Poh Lin Shum
A1 Alvin Milner
A1 Emma Link
A1 David L Ball
A1 Michael P. Mac Manus
YR 2012
UL http://jnm.snmjournals.org/content/53/7/1007.abstract
AB We investigated the incremental management impact and prognostic value of staging with 18F-FDG PET/CT in patients with non–small cell lung cancer (NSCLC) being considered for potentially curative therapies. Methods: Information on 168 consecutive patients with NSCLC being considered for surgery or definitive radiotherapy with curative intent before PET/CT was entered into a prospective database. The pre-PET/CT management plan, based on conventional imaging (conventional CT, appropriately supplemented by bone scintigraphy or other modalities), was defined prospectively by referring clinicians before PET/CT results became available. After PET/CT, actual clinical management was recorded, and patients were followed up until 5 y or death. The appropriateness of PET/CT management plans was assessed by biopsy when available, clinical follow-up, and survival analysis. Results: Stage was discordant on PET/CT and conventional imaging in 50.6% of patients (41.1% upstaged, 9.5% downstaged), with high management impact (change in treatment modality or curative intent) in 42.3% of patients. Both conventional imaging stage and PET/CT stage were strongly predictive of overall survival (OS) but there were greater differences between hazard rates and separations in the OS curves for stage groupings determined using PET/CT. OS was also strongly predicted by PET/CT-directed choice of therapy (P < 0.0001). Conclusion: PET/CT frequently affects patient management and strongly predicts OS in NSCLC, supporting the appropriateness of such changes.