Detection of extra pulmonary lesions with integrated PET/CT in the staging of lung cancer

¹ Dept of Radiology, University Hospitals Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium: Fax: +32-16-343765 E-mail: walter.dewever@uz.kuleuven.ac.be
² Dept of Nuclear Medicine, University Hospitals Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium

	Abstract

To assess retrospectively the additional value of PET/CT in the detection of unexpected extra-pulmonary lesions in the staging of patients with a malignant pulmonary lesion in comparison with computed tomography (CT) and positron emission tomography (PET) alone.

217 patients with a pathological proven lung tumour underwent PET/CT. CT, PET and PET/CT were evaluated on the detection of extra-pulmonary lesions. These abnormalities were compared with the final diagnosis obtained from the medical records. Statistical analysis was done.

108 lesions were clinically detected. PET/CT showed a sensitivity, specificity, positive and negative predictive value and accuracy of respectively 100%, 81%, 71%, 100% and 87% for the detection of extra-pulmonary lesions and 92%, 98%, 89%, 98% and 97% for the detection of malignant extra-pulmonary lesions. PET/CT was significantly better than CT(p<0.0001) and PET(p=0.0001) alone.

Conventional staging work-up has a poor sensitivity in detecting second primaries or unexpected metastases. The detection of malignant extra-pulmonary lesions is necessary for correct tumour staging. By combining both metabolic and anatomical information, PET/CT is able to depict more unexpected extra-pulmonary lesions than CT and PET alone and PET/CT provides more additional information of malignancy or benignancy of lesions detected with one of the two imaging modalities alone.

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				W. De Wever, S. Stroobants, J. Coolen, and J. A. Verschakelen Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration Eur. Respir. J., January 1, 2009; 33(1): 201 - 212. [Abstract] [Full Text] [PDF]