A prospective study of PET/CT in initial staging of small-cell lung cancer: comparison with CT, bone scintigraphy and bone marrow analysis

Ann Oncol. 2007 Feb;18(2):338-45. doi: 10.1093/annonc/mdl374. Epub 2006 Oct 23.

Abstract

Background: Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. Accurate and fast staging is mandatory when choosing treatment, but current staging procedures are time consuming and lack sensitivity.

Patients and methods: A prospective study was designed to examine the role of combined positron emission tomography/computed tomography (PET/CT) compared with standard staging (CT, bone scintigraphy and immunocytochemical assessment of bone marrow biopsy) of patients with SCLC. Thirty-four consecutive patients were included. Twenty-nine patients received initial PET/CT.

Results: PET/CT caused change of stage in 5/29 (17%). Excluding patients with unconfirmed findings or pleural effusion, the sensitivity for accurate staging of patients with extensive disease was the following: for standard staging 79%, PET 93% and PET/CT 93%. Specificity was 100%, 83% and 100%, respectively.

Conclusion: The results from this first study on PET/CT in SCLC indicates that PET/CT can simplify and perhaps even improve the accuracy of the current staging procedure in SCLC. A larger clinical trial, preferably with consequent histological confirmation in case of discordance, however, is warranted.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bone Marrow / pathology*
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary
  • Carcinoma, Small Cell / diagnostic imaging*
  • Carcinoma, Small Cell / pathology
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Prospective Studies
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18