Is Positron Emission Tomography (PET-CT) Scan Necessary For Patients With Early Non-Small Cell Lung Cancer (NSCLC)?

Author(s):  
Diana C. Lees ◽  
Lucy Carter ◽  
Mike J. Shackloth ◽  
Kay Kennedy ◽  
nicola Stevenson
2019 ◽  
Vol 71 (4) ◽  
pp. 741-746
Author(s):  
David E. Smith ◽  
Julian Fernandez Aramburu ◽  
Alejandro Da Lozzo ◽  
Juan A. Montagne ◽  
Enrique Beveraggi ◽  
...  

2016 ◽  
Vol 21 (3) ◽  
pp. 160-164
Author(s):  
Nadezhda A. Meshcheryakova ◽  
M. B Dolgushin ◽  
M. M Davydov ◽  
K. K Laktionov ◽  
A. A Odzharova ◽  
...  

Single photon emission computed tomography (SPECT) with the use of various tumor-tropic radiopharmaceutical preparations (RFP) has shown its effectiveness in the identification of tumor process in the lungs and metastatic lesions of mediastinal lymph nodes. In lung cancer such RFPs as Technetium-99m methoxy isobutyl isonitrile (MIBI) I) and 99mTc-depreotid got the largest traction. Increasingly frequently for the initial assessment of the prevalence ofprimary non-small cell lung cancer (NSCLC) there was used positron emission tomography combined with computed tomography (PET/CT) with 2-[18F]Fluoro-2-deoxy-d-glucose ([18F]FDG). The combined PET/CT image consider metabolic and morphological data, that allows to localize precisely the dissemination of the process and is used for the confirmation of the stage, detection of metabolically active extrathoracic lymph nodes, including those of the standard size (


Author(s):  
Ngo Minh Xuan ◽  
Huynh Quang Huy

Background: Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. positron emission tomography - computed tomography (PET/CT) has become increasingly used as an initial staging tool in patients with SCLC. We aimed to explore the relationships between primary tumor 18F-FDG uptake measured as the maximum standardized uptake value (SUV max) and clinical stage at PET/CT for small cell lung cancer patients (SCLC).Methods: Patients with SCLC who underwent 18F-FDG PET/CT scans before the treatment were included in the study at Bach Mai hospital of Vietnam, from November 2014 to May 2018. The primary tumor and secondary lesion SUVmax was calculated; the tumor size was measured; the TNM status was determined mainly by FDG PET/CT imaging according to The 8th Edition of the TNM Classification for Lung Cancer were recorded. An evaluation was made of the linear relationship between tumor size, T stage, N stage, and M stages of the patients and their SUVmax using Spearman’s correlation.Results: Total 37 cases (34 men and 3 women; age range 38 - 81 years, median 64 years) were analyzed. The average of primary tumor size and SUVmax were 5.95±2.77 cm and 10.21±4.75, respectively. The SUVmax of primary tumor is significantly greater than that of nodal and distant organ metastasis (10.21±4.75 vs 8.20±4.35 and 6.44±3.17, p<0.01). There was a moderate correlation between SUVmax and tumor size (r =0.596, p<0.001), tumor stage (r = 0.502, p<0.01) but not significant with nodal stage (r =-0.218, p=0.194), metastasis stage (r = -0.055, p=0.747), and overall stage (r=-0.060, p=0.725).Conclusions: SUVmax was significantly correlated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases in patients with SCLC.


2015 ◽  
Vol 49 (0) ◽  
pp. 1-10 ◽  
Author(s):  
Aline Navega Biz ◽  
Rosângela Caetano

<sec><title>OBJECTIVE</title><p> To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.</p></sec><sec><title>METHODS</title><p> The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.</p></sec><sec><title>RESULTS</title><p> The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively.</p></sec><sec><title>CONCLUSIONS</title><p> The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.</p></sec>


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