The usefulness of 18F-FDG PET/CT in follow-up and recurrence detection for patients with lung carcinoma and its impact on the survival outcome

Gihan Hassan Gamal

doi:10.1186/s43055-021-00504-2

Abstract

BackgroundWe assess the usefulness of 18F-FDG PET/CT for detection of recurrent or residual tumor in post treatment patients with NSCLC and comparing the results with CECT, and we evaluate its impact to the clinical assessment and overall survival of lung cancer patients.ResultsA prospective study of 63 patients with potentially resectable NSCLC, were divided into 2 groups according to the initial staging of the disease and the early response to treatment.Group A (n=29) patients were treated by curative treatment, and group B (n=34) patients were treated by palliative treatment.Evaluation of patients was done during the follow-up period clinically every 3 months and by 18F-FDG PET/CT and CECT imaging at 6 months intervals.In group A, 18F-FDG PET/CT correctly diagnosed all recurrent or residual tumors (n=7) whereas CECT diagnosed only 5 with 2 false negative cases.In group B, 18F-FDG PET/CT correctly diagnosed all recurrent or residual tumors (n=23) whereas CECT diagnosed 16 patients with 7 false negative cases.By comparison of 18F-FDG PET/CT and CECT in detection of residual or recurrent lung cancer (n=30), the sensitivity, specificity, PPV, NPV, and accuracy of 18F-FDG PET/CT were 100%, 92%, 92%, 100%, and 96% respectively, while of CECT were 72%, 95%, 94%, 79%, and 84% respectively in correlation with reference standard data. The calculated SUV max ranged from 2.1 to 4.9.There was a significant difference in overall survival between patients in routine scan who had positive 18F FDG PET/CT result (median survival 18 months) and those who had negative result (median survival 45 months) (P<0.0001).Conclusion18 F-FDG PET/CT plays an important role in distinguishing post treatment changes from tumor recurrence in patients with lung cancer. Follow-up or surveillance 18 F-FDG PET/CT is a prognostic indicator for overall survival of patients.

Highlights

We assess the usefulness of 18F-FDG 18F fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for detection of recurrent or residual tumor in post treatment patients with Non-small cell lung cancer (NSCLC) and comparing the results with Contrastenhanced computed tomography (CECT), and we evaluate its impact to the clinical assessment and overall survival of lung cancer patients
The aim of this study was to assess the usefulness of 18F FDG PET/CT for detection of residual or recurrent tumors in post treatment NSCLC patients comparing the results with CECT, and to evaluate its impact to the clinical assessment and survival outcome of lung cancer patients
We assess the usefulness of 18 F-FDG PET/CT in differentiating post treatment changes in patient with NSCLC from tumor relapse comparing the results with CECT, and we evaluate its impact to the clinical assessment and overall survival of lung cancer patients

Summary

Introduction

We assess the usefulness of 18F-FDG PET/CT for detection of recurrent or residual tumor in post treatment patients with NSCLC and comparing the results with CECT, and we evaluate its impact to the clinical assessment and overall survival of lung cancer patients. Lung carcinoma is one of the leading causes of cancerrelated mortality worldwide It is divided histologically into two main types: NSCLC accounts for 85% of cases and SCLC 10-15% of cases [1]. The follow-up radiological imaging by using response evaluation criteria in solid tumor (RECIST criteria) of lung cancer patients using CT with or without contrast media to detect tumor recurrence was widely accepted in determining treatment response. It depends on the size and mass changes occurred to the tumor post treatment, irrespective of the tumor viability, lowering its diagnostic performance with decreasing sensitivity and specificity for detection of cancer recurrence [4]

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