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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kruijf-Arens, A. Articles by Vogel, W. PubMed Articles by Kruijf-Arens, A. Articles by Vogel, W.

Thoracic range FDG-PET/CT is feasible for detection and staging of lung cancer

¹ NM, NKI-AvL, Amsterdam, Netherlands; ² NM, BVI, Tilburg, Netherlands; ³ NM, AtriumMC, Heerlen, Netherlands; ⁴ NM, UMCN, Nijmegen, Netherlands; ⁵ NM, Rijnstate, Arnhem, Netherlands

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Objectives: FDG-PET/CT for evaluation of lung cancer is usually performed "wholebody" (head-thighs). This includes areas with a low pre-test likelihood of metastases, i.e. the head/neck and lower abdominen/pelvis. These areas are not included in standard diagnostic CT and thus yield logistical issues in integrated PET/CT. We evaluated the feasibility of limited range FDG-PET/CT for evaluation of lung cancer.

Methods: In a retrospective multicenter trial in the Netherlands, 1069 FDG-PET/CT scans of patients with suspected or recently proven lung cancer were evaluated. The occurrence of lesions suspect for malignancy in the head/neck above the shoulder line (area HN) and the abdomen/pelvis below the tip of the liver (area AP) was noted, with their impact on further diagnostics, staging, and therapy.

Results: HN revealed lesions in 7.3% of patients, of which 3.2% were considered metastases, but only 0.4% with impact on staging and 0.2% on therapy. No second primaries were found. AP showed lesions in 16.1%, of which 9.1% metastases, but only 0.8% had impact on staging and 0.7% on therapy. Furthermore, 6 second primary tumors were confirmed (0.6%). In total, NOT scanning HN+AP would have reduced (mostly irrelevant) PET findings in 19.9% and would have reduced cost and delay due to additional diagnostic procedures in 7.6%, while understaging with therapeutic consequences in 0.9% and missing proved second primaries in 0.6%.

Conclusions: Limited range thoracic FDG-PET/CT is a feasible alternative for initial evaluation of (suspected) lung cancer. It obviates low-dose CT, allows faster patient throughput on scarce PET resources, and reduces additional diagnostic procedures and delay, while hardly affecting the clinical value of FDG-PET.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kruijf-Arens, A. Articles by Vogel, W. PubMed Articles by Kruijf-Arens, A. Articles by Vogel, W.