Comparison of PET/CT and CT in Preoperative Grading of non-Small Cell Lung Cancer

42018

Objectives: The aim of our study was to compare the diagnostic effectiveness of positron emission tomography/computed tomography (PET/CT) versus stand-alone computed tomography (CT) in the staging of non-small cell lung cancer (NSCLC) before thoracic surgery. Materials and Method: From August 2006 to January 2008, this retrospective study included 49 patients (4 women, 45 men; mean age: 63.3) with NSCLC. PET/CT and stand-alone CT images which obtained before thoracic surgery, were evaluated separately by two different physician teams for each imaging modality. Tumor stages were determined by using TNM and AJCC staging systems. Histopathological results were used as gold standard. McNemar tests were applied for the diagnostic difference between PET/CT and stand-alone CT. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for both modalities were calculated in the staging of the disease. Result: Histopathologically, the distribution of tumor stages was T1 in 11 patients, T2 in 21 patients, T3 in 8 patients and T4 in 9 patients. N0 disease in 31 patients, N1 in 13 patients and N2 in 5 patients were present in the study. Overall tumor stage was correctly determined in 39 patients (77.6%) at PET/CT and 40 patients (81.6%) at stand-alone CT. There was no statistically significant difference between PET/CT and stand-alone CT in terms of tumor staging (p 0.05). For the depiction of the regional lymph node metastasis, the sensitivity, specificity, accuracy, PPV and NPV of PET/CT were 64%, 97.2%, 93.7%, 72.2% and 95.8%, respectively; whereas those of stand-alone CT were 72%, 93.4%, 91.2%, 56.3% and 96.6%. False-negative interpretations of malignant nodes were 9 at PET/CT and 7 at standalone CT, respectively. When PET/CT was compared with stand-alone CT for the false positive interpretations of non-malignant nodes, there were 6 false-positive interpretations at PET/CT and 14 at stand-alone CT. Conclusion: The results of this study showed that PET/CT had no significant superiority over stand-alone CT images in the staging of NSCLC. Despite discrepancy of our data compared to the results of other similar studies, it seems more likely to be related to the relatively higher number of patients with early nodal stage disease in the present study.

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positron emission tomography and computed tomography scan , computed tomography scan , lung cancer , events

Kocatepe Medical Journal

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Kocatepe Medical Journal