JTO: PET/CT can be used to fast track lung cancer diagnosis

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PET/CT can be used to diagnose lung cancer in a “fast-track” setting, according to a study published in the October issue of the Journal of Thoracic Oncology.

Tjeerd S. Aukema, MD, from the Netherlands Cancer Institute in Amsterdam, and colleagues performed a prospective study on 114 patients with pulmonary symptoms or abnormal chest x-ray who were referred for fast-track assessment at the Netherlands Cancer Institute between March 2005 and September 2007.

According to the authors, evaluation of each patient was done in a multi-disciplinary setting, which included F18-FDG PET, diagnostic CT and bronchoscopy (including biopsy), with histopathological evaluation as the reference standard. The fast-track model tested patients over the course of one day.

In 92 percent of the patients a final diagnosis was achieved. Malignancy was diagnosed in 84 percent of the patients, non-small cell lung cancer in 67 percent, small cell lung cancer in 7 percent and metastases or other malignancies in 10 percent. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT for the presence of malignancy were 97, 56, 90, 92 and 77 percent, respectively.

The authors noted that almost half of the patients with a malignancy were scheduled for curative treatment--29 patients for surgery and 14 patients for chemoradiotherapy.

"Our approach resulted in a fast and accurate diagnosis and allowed for treatment to be initiated without delays." said Aukema. "These results suggest that availability of fast-track assessment facilities can contribute to appropriate and timely evaluation of lung malignancies."

On the basis of their findings, the researchers concluded that in a outpatient fast-track setting, PET/CT provides "valuable information for diagnosing lung cancer, with a high positive predictive value, and is useful for clinical decision-making."