PET/CT implication on bronchogenic carcinoma TNM staging and follow-up using RECIST/PERCIST criteria: a comparative study with CT

Ahmed M Osman,Hazem I Korashi

doi:10.1186/s43055-020-0133-5

Abstract

BackgroundTo evaluate the role of PET/CT on bronchogenic carcinoma staging as well as treatment response evaluation on follow-up compared to CT study alone.MethodsA prospective study of 60 patients confirmed histopathologically to have non-small cell bronchogenic carcinoma, 30 of them came for staging (group T) while the rest 30 came for follow-up (group F) to assess therapy response. All patients underwent PET/CT with data analysis done using the eighth edition tumor, nodal, metastatic staging (TNM) staging for group T and RECIST/PERCIST criteria for group F. The CT data alone transferred to a blind radiologist for analysis using the same parameters. The results were collected and compared.ResultsRegarding group T, 12 patients showed different TNM staging between PET/CT and CT alone, 5 cases with different T stagings, 4 cases with different N stagings, and 5 cases with different M stagings. Also, 8 cases showed different surgical stagings. Regarding group F, 9 cases showed a difference between RECIST obtained by CT and PERCIST obtained by PET/CT with most of the cases (6 cases) showed change from partial or stable response to progressive response.ConclusionPET/CT has a significant role in TNM staging of bronchogenic carcinoma more at T2 staging due to its ability to differentiate the tumoral mass from the nearby pulmonary reaction. Also, PET/CT makes a difference in tumoral follow-up by its ability to detect the functional changes even before structural changes. Finally, PET/CT is a very important tool in management strategy.

Highlights

To evaluate the role of PET/CT on bronchogenic carcinoma staging as well as treatment response evaluation on follow-up compared to CT study alone
Sixty patients with a histopathological diagnosis of NSCLC were included in our study with the age of the patients ranging from 39 to 72 years old and the mean age was 49 ± 12.5 SD years. 63.3% of the patients were male with 71.7% of all patients showing a positive history of smoking, which is considered one of the most important risk factors for bronchogenic carcinoma
This study demonstrates the significance of PET/CT uses during the evaluation of cases with non-small cell bronchogenic carcinoma, either during staging or during follow-up to assess the therapeutic response

Summary

Introduction

To evaluate the role of PET/CT on bronchogenic carcinoma staging as well as treatment response evaluation on follow-up compared to CT study alone. Bronchogenic carcinoma classified histopathologically into either non-small cell (NSCLC) or small cell type with non-small cell is the commonest representing up to 87% of cases [2]. The eighth edition of tumor, nodal, metastatic staging (TNM) staging is the most recent and updated edition for bronchogenic carcinoma staging replacing the known seventh edition since January 2017. Bronchogenic carcinoma staging is crucial for treatment strategy, planning, and prognosis prediction with radiological imaging play a cornerstone role in staging [4, 5]. Patients with stage IIIA receive chemotherapy and radiotherapy followed by surgery if downstaging occurred while for patients with stage IIIB or IV, the surgery has no role in their treatment [6]

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