Chest
Clinical InvestigationsNUCLEAR MEDICINEThe Utility of 99mTc Depreotide Compared With F-18 Fluorodeoxyglucose Positron Emission Tomography and Surgical Staging in Patients With Suspected Non-small Cell Lung Cancer
Section snippets
Patients
After signing an informed consent statement approved by our Institutional Review Board for the study of human subjects, 166 subjects (48 women and 118 men; median age, 68 years; range, 40 to 87 years) who had abnormal chest CT scan results and were suspected of having operable and potentially curable lung cancer were prospectively enrolled into the study. All were scheduled to have a definitive diagnosis made and tumor staging performed by surgical intervention.
FDG PET Imaging and Interpretation
Each patient underwent a FDG PET
Primary Lung Lesion
Nine of the 166 subjects (5%) were excluded from analysis of the primary lesion because metastatic disease was proven before the biopsy of this lesion (n = 3), surgery was medically contraindicated (n = 2), or the patient refused any procedures to evaluate the lung lesion (n = 4). In the 157 subjects with complete data available, there were 122 malignant and 35 benign primary lesions. The median lesion size (average of the two longest dimensions on the chest CT) was 2.2 cm (range, 0.5 to 10.5
Discussion
Noninvasive testing results from patients with suspected lung cancer are frequently unreliable. Conventional imaging techniques have a limited diagnostic accuracy since interpretation relies principally on lesion size and other nonspecific findings.3 For this reason, newer imaging methods that do not rely solely on lesion size have been evaluated in patients with lung cancer.
We have found that FDG PET and 99mTc depreotide scans are equally sensitive for the detection of lung cancer at the
Conclusion
Our findings demonstrate that FDG PET and 99mTc depreotide have equally high sensitivities for the detection of lung cancer in the primary lesion. Therefore, since the likelihood of non-small cell lung cancer is low (particularly when the prevalence of cancer in the population is not > 50%) when either test result is negative, test selection should be based on other variables such as availability and convenience (99mTc depreotide, unlike FDG PET, uses standard nuclear medicine gamma cameras and
ACKNOWLEDGMENT
The authors thank Mitchell Thomas, CNMT; Jenifer Swearingen, RN; Amy Nibaur, RN; Dennis Sass, RN; Craig Larson, PA-C; John Richmond, CNMT; and Nicholas Rossi, MD, for assisting with this project.
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This work was perfomed at the Iowa City VA Medical Center and the University of Iowa, Roy J. and Lucille A. Carver College of Medicine.
Research support was provided in part by Berlex Laboratories, Inc.