Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer

被引:164
作者
Brink, I [1 ]
Schumacher, T
Mix, M
Ruhland, S
Stoelben, E
Digel, W
Henke, M
Ghanem, N
Moser, E
Nitzsche, EU
机构
[1] Univ Hosp, Div Nucl Med, Freiburg, Germany
[2] Diakonie Clin Freiburg, Div Nucl Med, Freiburg, Germany
[3] Univ Hosp, Div Thorac Surg, Freiburg, Germany
[4] Univ Hosp, Div Hematol & Oncol, Freiburg, Germany
[5] Univ Hosp, Div Radiat Therapy, Freiburg, Germany
[6] Univ Hosp, Div Diagnost Radiol, Freiburg, Germany
[7] Univ Hosp, Div Nucl Med, Basel, Switzerland
关键词
small-cell lung cancer; F-18]FDG-PET; primary staging; radionuclide imaging;
D O I
10.1007/s00259-004-1606-x
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: The purpose of this study was to evaluate the impact of [F-18]fluorodeoxy-D-glucose positron emission tomography (FDG-PET) on the primary staging of patients with small-cell lung cancer (SCLC). Methods: FDG-PET was performed in 120 consecutive patients with SCLC during primary staging. In addition, brain examinations with both FDG-PET and cranial magnetic resonance imaging (MRI) or computed tomography (CT) were performed in 91 patients. Results of FDG-PET were compared with those of conventional staging procedures. FDG-PET detected markedly increased FDG uptake in the primary tumours of all 120 patients (sensitivity 100%). Results: Complete agreement between FDG-PET results and other staging procedures was observed in 75 patients. Differences occurred in 45 patients at 65 sites. In 47 sites the FDG-PET results were proven to be correct, and in ten, incorrect. In the remaining eight sites, the discrepancies could not be clarified. In 14/120 patients, FDG-PET caused a stage migration, correctly upstaging ten patients to extensive disease and downstaging three patients by not confirming metastases Of the adrenal Glands suspected on the basis of CT. Only 1/120 patients was incorrectly staged by FDG-PET, owing to failure to detect brain metastases. In all cases the stage migration led to a significant change in the treatment protocol. Sensitivity of FDG-PET was significantly superior to that of CT in the detection of extrathoracic lymph node involvement (100% vs 70%, specificity 98% vs 94%) and distant metastases except to the brain (98% vs 83%, specificity 92% vs 79%). However, FDG-PET was significantly less sensitive than cranial MRI/CT in the detection of brain metastases (46% vs 100%, specificity 97% vs 100%). Conclusion: The introduction of FDG-PET in the diagnostic evaluation of SCLC will improve the staging results and affect patient management, and may reduce the number of tests and invasive procedures.
引用
收藏
页码:1614 / 1620
页数:7
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