The clinical application research of positron emission tomographic-CT in lung cancer

Objective: To evaluate the clinical value of [18F] fluoro-2-deoxy-glucose (18F-FDG) positron emission tomographic (PET)-CT in the diagnosis, staging, therapy, and monitoring of lung cancer. Methods: PET-CT was performed in 80 patients with lung cancer. The up take of 18F-FDG was analyzed and cancer staging was determined by using TNM and American Joint Committee on Cancer staging systems. Histopathologic results served as the reference standard. The statistical significance of differences among CT and PET-CT was determined by using the SPSS 10.0 χ2 test. Results: (1) All lesions of lung cancer showed intense up take of 18F-FDG. The most intense up take was showed in adenosquamous carcinoma and poorly differentiated squamous carcinoma. (2) Overall tumor staging was correctly classified as N stage with CT in 48 patients and with PET-CT in 61 patients. Differences in the accuracy of overall tumor staging between PET-CT and CT (P<0.01) were significant. Primary tumor staging was correctly determined in more patients with PET-CT than with CT alone. Sensitivity, specificity, positive predictive value, and negative predictive value were 80.09%, 97.14%, 96.11%, and 84.70%, respectively with PET-CT; 56.48%, 71.02%, 63.21%, and 64.93%, respectively with CT. 17 distant metastases were detected in 11 patients with CT, 39 distant metastases were detected in 16 patients with PET-CT. PET-CT findings when compared with CT findings led to a treatment change for 18 patients. Conclusions: 18F-FDG PET-CT is an excellent modality in the diagnosis and staging of lung cancer. It has a positive effect on the treatment and prognostic monitoring. (authors)