PET-CT planning in lung cancerDiagnostic and staging impact of radiotherapy planning FDG-PET-CT in non-small-cell lung cancer
Section snippets
Study population
Patients with biopsy-proven newly diagnosed NSCLC undergoing both staging and planning FDG-PET-CT and planned for curative thoracic radiotherapy were retrospectively recruited from Liverpool Hospital. Only patients with planning PET-CT performed within 8 weeks of the staging PET-CT were included for analysis, as this was thought to be a pragmatic and clinically relevant timeframe. Patients who received chemotherapy during this time were excluded from the study. Patients who underwent staging
Results
Twenty-six consecutive patients (eight female, 18 male; median age = 69 years, range 54–80 years) from October 2007 to February 2010 met the inclusion criteria and were included for analysis. Histological subgroups comprised of squamous cell carcinoma (n = 9 patients), adenocarcinoma (n = 7) and large cell carcinoma (n = 10). TNM 6 staging classification [14] comprised of four patients in stage IA, one in IB, three in IIA, two in IIB, 15 in IIIA and one in IIIB. The mean scan interval between the staging
Discussion
This study demonstrates that a dedicated FDG-PET scan performed for RT planning purpose can be a potentially powerful imaging tool to detect interval disease progression at the functional level compared to CT alone. Overall, the planning PET detected progressive disease in 16 patients (61%), compared to 4 patients (15%) by CT component of the planning PET-CT. The planning PET detected PD in primary tumour in seven patients, 20 new nodal sites in 12 new nodal stations and nine patients, three
Conflict of interest
None.
Role of funding source
The scans, collection and analysis of the data were funded internally by the Department of Nuclear Medicine and PET with no external sponsors.
Acknowledgements
We thank Andrew Chicco from the Department of Nuclear Medicine and PET for preparing the table and figures. We thank the doctors from Liverpool and Macarthur Cancer Therapy Centres, Cardiothoracic Surgery and Respiratory Departments participating at the weekly Lung Multidisciplinary Clinic for their patient referrals and advice regarding this study.
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