Original article: general thoracicThe accuracy of integrated PET-CT compared with dedicated pet alone for the staging of patients with nonsmall cell lung cancer
Section snippets
Patients
From August 2002 to October 2003, all patients presenting to one general thoracic surgeon (R.J.C.) with an indeterminate pulmonary nodule or a biopsy-proven NSCLC who underwent an integrated PET-CT using a GE Discovery LS PET-CT scanner (General Electric, Milwaukee, WI) were eligible for this study.
Inclusion criteria into this study required patient age of 19 years or greater, a whole body integrated PET-CT scan performed at our institution within 4 weeks of surgery, a chest CT scan performed
Results
There were 129 patients (77 men) with a median age of 66 years (range, 24 to 87). Seventy-nine patients underwent thoracotomy with complete (RO) resection and thoracic lymphadenectomy. Seventy-one patients had a lobectomy, 4 had a segmentectomy, and 4 a pneumonectomy. In addition, 10 patients had exploration and were found to have unsuspected N2 or M1 disease. Suspected N2 disease was evaluated before thoracotomy using mediastinoscopy (n = 24), transesophageal ultrasound with fine-needle
Comment
The 5-year survival of NSCLC is only 14%. One contributing factor is that patients with presumed early stage Ib or II NSCLC who undergo resection are often misstaged preoperatively and probably have more advanced disease. For these reasons PET scanning using FDG has become popular 7, 8, 9, 10, 11. It has been shown that PET is more accurate than CT, but there still remain inaccuracies 12, 13, 14, 15 Our recent study on 400 patients has illustrated many of PET's weaknesses, including the high
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