The management impact of clinically significant incidental lesions detected on staging FDG PET-CT in patients with non-small cell lung cancer (NSCLC): An analysis of 649 cases

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• 作者：Michael Lin^a ; ^b ; ^{michael.lin@swsahs.nsw.gov.au} ; Chaitanya Ambati^a
• 关键词：FDG ; PET ; PET-CT ; Positron Emission Tomography ; Lung cancer ; NSCLC ; Staging
• 刊名：Lung Cancer
• 出版年：2012
• 期刊代码：187_01695002
• 类别：med
• 出版时间：June, 2012
• 卷：76
• 期：3
• 页码：344-349
• 文件大小：316 K

摘要

To evaluate FDG PET-CT in the detection of unexpected pre-malignancy or second malignancy at the initial staging of patients with histologically proven non-small cell lung cancer (NSCLC) and its impact on management.

Methods

Staging FDG PET-CT scans acquired between February 2006 and July 2010 in 649 patients (M = 389; F = 260) with NSCLC were reviewed for the presence of unexpected pre-malignancy or second primary. A 鈥淭rue-Positive鈥?lesion represented a second primary or pre-malignant lesion. A 鈥淔alse-Positive鈥?lesion was due to benign causes or an atypical site of metastasis from NSCLC.

Results

77 (12%) patients were identified on PET-CT as having a potential pre-malignancy or second primary. 39 out of 77 (51%) patients had diagnostic verification where histopathology served as reference standard in 33 patients (85%) and the rest had endoscopy and progress PET-CT scans. 20 patients (3.1%) had a second primary (n = 11) or pre-malignant lesions comprising dysplastic colorectal polyps (n = 9), and additional therapy and/or management change for the index tumour was instigated in 17 patients (85%). In patients with a second primary, 3 (27%) patients had a high impact change in management from an initial curative intent to palliative.

Conclusion

Staging FDG PET-CT is highly valuable in identifying second primary cancers or pre-malignant lesions in patients with NSCLC. When a second primary is detected on PET-CT, there is a high impact change in management in 27%of patients.