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Radiolabeled PET scan helpful in lung cancer staging


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Radiolabeled PET scan helpful in lung cancer staging

David Douglas

Reuters Health

Posting Date: May 12, 2004

Last Updated: 2004-05-12 12:15:34 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Compared to CT scanning, positron emission tomography (PET) with radiolabeled [18F]-2-Fluoro-DeoxyD-Glucose (FDG) can improve the accuracy of staging in patients with resectable non-small cell lung cancer (NSCLC), according to researchers. However, mediastinoscopy was 100% accurate, and, say the investigators, "remains the most economically reasonable strategy with excellent sensitivity."

"As a clinician, I continue to use the FDG-PET scan frequently in the evaluation of lung cancer patients," lead investigator Dr. Rosemary F. Kelly told Reuters Health. "It is a new technology that is enhancing our ability to preoperatively stage patients in order to optimize each patient's therapy."

As Dr. Kelly of the University of Minnesota, Minneapolis and colleagues report in the April issue of Chest, they retrospectively reviewed data on 69 NSCLC patients who had had preoperative CT and FDG-PET scans. Of these patients, 32 also underwent mediastinoscopy.

The sensitivity of CT scanning was 46% compared to 62% for FDGPET. For specificity, the corresponding proportions were 86% versus 98%, for accuracy, 78% versus 91%, for positive predictive value, 43% versus 89% and for negative predictive value, 87% versus 92%.

FDG-PET imaging improved staging accuracy compared to CT, but in patients with adenocarcinoma and mediastinal lymph nodes of less than 1 cm, they add, it "cannot yet replace mediastinoscopy."

As Dr. Kelly concluded, "I have found that FDG-PET scans are not quite as specific for defining malignancy or metastasis as originally hoped, and so like most new technologies, it needs to be implemented with caution and within the context of standard practices."

Chest 2004;125:1413-1423.

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