Author of

• 13707

  +

  P1.06 - Poster Session/ Screening and Early Detection (ID 218)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 13731

    +

    P1.06-024 - Patterns of ¹⁸F FDG-PET/CT Studies in Patients with Suspected or Confirmed Lung Cancer - A Johannesburg Academic Hospital Perspective (ID 527)

    09:30 - 09:30  |  Author(s): M.D.T. Vangu
    • Abstract

    Background:
    Lung cancer incidence has increased rapidly in developing countries over the last few decades. It is estimated to account for nearly one-fifth of cancer-related deaths in South Africa. Imaging plays an integral role in the evaluation of patients with lung cancer. 2-[[18]F] fluoro-2-deoxy-d- positron emission tomography ([18]F FDG-PET) is now an accepted part of the imaging assessment. Integrated FDG-PET/ CT imaging is recognised as being superior to PET alone and CT alone in the imaging of lung cancer especially for staging of untreated non-small cell lung cancer (NSCLC). An audit was conducted to describe the patterns of disease in our centre.
    
    Methods:
    Retrospective audit which included 89 studies performed for patients with suspected or histologically confirmed lung cancer referred to us for PET/CT from September 2008 to March 2015. PET/CT reports of the patients were retrieved together with relevant clinical information from the case files whenever necessary. Over two-third (71%) of patients were referred for diagnosis/staging, others for re-staging (19%) and response to therapy (10%). All of the studies were reported by qualified and experienced Nuclear Medicine Physicians and the CT components of these studies were also read in conjunction with qualified Radiologists.
    
    Results:
    There were 89 scans from 87 patients. Majority of the patients were males (60%) and the mean age was 61.0 ± 9.4 years. About 42% (n=37) of the studies were performed on patients with histologically confirmed lung cancer; of the remaining indications, 15% (n=13) were referred for solitary pulmonary nodule and 43% (n=39) for multiple pulmonary nodules and masses. More than two-thirds (71%) were referred for staging, about one fifth (19%) for re-staging and 10% to assess response to treatment. The vast majority (94%) of known lung cancer were NSCLC that included adenocarcinoma (40%), squamous cancer (29%) and NSCLC not otherwise specified [NOS] (26%). F-18 FDG PET/CT showed almost an equal number in the presence (37%) or absence of metastases (36%). No significant differences were noted on FDG PET uptake between the three subtypes mentioned above (p > 0.05, Chi square). However, there was a tendency for a difference between these histological subtypes [squamous, adenocarcinoma and NSCLC NOS] for the presence of metastases (p<0.09) and the sites of metastatic predilection (p<0.08). Just more than half (53%) of patients showed evidence of positive regional nodal involvement on PET. All SPN were visualised on PET (sensitivity 100%) with about 57% with high FDG uptake (mean SUV=7.71) and about 43% with low FDG uptake (mean SUV=1.05). Correlation with histology was available for 38% of all SPNs and FDG PET correctly identified all of them as malignant or benign (100% specificity).
    
    Conclusion:
    [18]F FDG-PET/CT is useful in characterising solitary pulmonary nodules (SPNs) and staging as well as monitoring treatment response in lung cancer. Although it cannot replace histological confirmation of nodal and metastatic involvement, it serves as a roadmap to identify areas for tissue diagnosis. The detection of metastases may alter the therapeutic decision of NSCLC.