Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning

被引:80
作者
Ashraf, H. [1 ]
Dirksen, A. [2 ,3 ]
Loft, A. [4 ]
Bertelsen, A. K. [4 ]
Bach, K. S. [1 ]
Hansen, H. [1 ]
Pedersen, J. H. [5 ]
Mortensen, J. [3 ,4 ]
机构
[1] Gentofte Univ Hosp, Dept Radiol, DK-2900 Hellerup, Denmark
[2] Gentofte Univ Hosp, Dept Resp Med, DK-2900 Hellerup, Denmark
[3] Univ Copenhagen, Fac Hlth Sci, DK-1168 Copenhagen, Denmark
[4] Univ Copenhagen, Rigshosp, Dept Clin Physiol Nucl Med & PET, DK-1168 Copenhagen, Denmark
[5] Univ Copenhagen, Rigshosp, Dept Thorac Surg RT, DK-1168 Copenhagen, Denmark
关键词
SMALL PULMONARY NODULES; COMPUTED-TOMOGRAPHY; GROWTH-RATE; MANAGEMENT; DIAGNOSIS; SURVIVAL; SOLITARY; NELSON; DESIGN; TRIAL;
D O I
10.1136/thx.2010.136747
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
100201 [内科学];
摘要
Background In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules. Methods From the Danish Lung Cancer Screening Trial, participants with indeterminate nodules who were referred for a 3-month rescan were investigated. Resected nodules and indolent nodules (ie, stable for at least 2 years) were included. Between the initial scan and the 3-month rescan, participants were referred for PET. Uptake on PET was categorised as most likely benign to malignant (grades I-IV). VDT was calculated from volume measurements on repeated CT scans using semiautomated pulmonary nodule evaluation software. Receiver operating characteristic (ROC) analyses were used to determine the sensitivity and specificity of PET and VDT. Results A total of 54 nodules were included. The prevalence of lung cancer was 37%. In the multivariate model both PET (OR 2.63, p < 0.01) and VDT (OR 2.69, p < 0.01) were associated with lung cancer. The sensitivities and specificities of both PET and VDT were 71% and 91%, respectively. Cut-off points for malignancy were PET > II and VDT < 1 year, respectively. Combining PET and VDT resulted in a sensitivity of 90% and a specificity of 82%; ROC cut-off point was either PET or VDT indicating malignancy. Conclusion PET and VDT predict lung cancer independently of each other. The use of both PET and VDT in combination is recommended when screening for lung cancer with low-dose CT.
引用
收藏
页码:315 / 319
页数:5
相关论文
共 26 条
[1]
Lung nodule volumetry: segmentation algorithms within the same software package cannot be used interchangeably [J].
Ashraf, H. ;
de Hoop, B. ;
Shaker, S. B. ;
Dirksen, A. ;
Bach, K. S. ;
Hansen, H. ;
Prokop, M. ;
Pedersen, J. H. .
EUROPEAN RADIOLOGY, 2010, 20 (08) :1878-1885
[2]
Symptoms and the early diagnosis of lung cancer [J].
Birring, SS ;
Peake, MD .
THORAX, 2005, 60 (04) :268-269
[3]
CUMMINGS SR, 1986, AM REV RESPIR DIS, V134, P449
[4]
Preoperative Staging of Lung Cancer with Combined PET-CT. [J].
Fischer, Barbara ;
Lassen, Ulrik ;
Mortensen, Jann ;
Larsen, Soren ;
Loft, Annika ;
Bertelsen, Anne ;
Ravn, Jesper ;
Clementsen, Paul ;
Hogholm, Asbjorn ;
Larsen, Klaus ;
Rasmussen, Torben ;
Keiding, Susanne ;
Dirksen, Asger ;
Gerke, Oke ;
Skov, Birgit ;
Steffensen, Ida ;
Hansen, Hanne ;
Vilmann, Peter ;
Jacobsen, Grete ;
Backer, Vibeke ;
Maltbaek, Niels ;
Pedersen, Jesper ;
Madsen, Henrik ;
Nielsen, Henrik ;
Hojgaard, Liselotte .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 361 (01) :32-39
[5]
Positron emission tomography of incidentally detected small pulmonary nodules [J].
Fischer, BM ;
Mortensen, J ;
Dirksen, A ;
Eigtved, A ;
Hojgaard, L .
NUCLEAR MEDICINE COMMUNICATIONS, 2004, 25 (01) :3-9
[6]
Positron emission tomography in the diagnosis and staging of lung cancer: a systematic, quantitative review [J].
Fischer, BMB ;
Mortensen, J ;
Hojgaard, L .
LANCET ONCOLOGY, 2001, 2 (11) :659-666
[7]
Growth rate of small lung cancers detected on mass CT screening [J].
Hasegawa, M ;
Sone, S ;
Takashima, S ;
Li, F ;
Yang, ZG ;
Maruyama, Y ;
Watanabe, T .
BRITISH JOURNAL OF RADIOLOGY, 2000, 73 (876) :1252-1259
[8]
Early Lung Cancer Action Project: overall design and findings from baseline screening [J].
Henschke, CI ;
McCauley, DI ;
Yankelevitz, DF ;
Naidich, DP ;
McGuinness, G ;
Miettinen, OS ;
Libby, DM ;
Pasmantier, MW ;
Koizumi, J ;
Altorki, NK ;
Smith, JP .
LANCET, 1999, 354 (9173) :99-105
[9]
Henschke CI, 2006, NEW ENGL J MED, V355, P1763, DOI 10.1056/NEJMoa060476
[10]
HESTER A, 2007, RADIOLOGY, V245, P888