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Non-small cell carcinoma: Comparison of postoperative intra- and extrathoracic recurrence assessment capability of qualitatively and/or quantitatively assessed FDG-PET/CT and standard radiological examinations
Authors:Yumiko Onishi  Hisanobu KoyamaMunenobu Nogami  Daisuke TakenakaKeiko Matsumoto  Takeshi YoshikawaSumiaki Matsumoto  Yoshimasa ManiwaYoshihiro Nishimura  Kazuro Sugimura
Institution:a Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan
b Department of Radiology, Yamanashi University, Shimokato, Yamanashi, Japan
c Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
d Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
Abstract:

Purpose

The purpose of this study was to compare the capability of integrated FDG-PET/CT for assessment of postoperative intra- and extrathoracic recurrence in non-small cell lung cancer (NSCLC) patients with that of standard radiological examinations.

Materials and methods

A total of 121 consecutive pathologically diagnosed NSCLC patients (80 males, 41 females; mean age, 71 years) underwent pathologically and surgically confirmed complete resection, followed by prospective integrated FDG-PET/CT and standard radiological examinations. Final diagnosis of recurrence was based on the results of more than 12 months of follow-up and/or pathological examinations. The probability of recurrence was assessed with either method for each patient by using 5-point visual scoring system, and final diagnosis was made by consensus between two readers. ROC analysis was used to compare the capability of the two methods for assessment of postoperative recurrence on a per-patient basis. The ROC-based positive test was used to determine optimal cut-off value for FDG uptake measurement at a site suspected on the basis of qualitatively assessed PET/CT. Finally, sensitivities, specificities and accuracies of all methods were compared by means of McNemar's test.

Results

Areas under the curve of qualitatively assessed PET/CT and standard radiological examinations showed no significant differences (p > 0.05). At an optimal cut-off value of 2.5, specificity and accuracy of quantitatively and qualitatively assessed PET/CT were significantly higher than those of qualitatively assessed PET/CT and standard radiological examinations (p < 0.05).

Conclusion

Accuracy of assessment of postoperative intra- and extrathoracic recurrence in NSCLC patients by qualitative and/or quantitative FDG-PET/CT is equivalent to or higher than that by standard radiological examinations.
Keywords:PET  CT  Lung cancer  Recurrence  Surgery  Survival
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