Comparing Two Imaging Methods for Follow-Up of Lung Cancer Treatment: A Randomized Pilot Study.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
02 2019
Historique:
received: 07 03 2018
revised: 06 08 2018
accepted: 13 08 2018
pubmed: 8 10 2018
medline: 13 11 2019
entrez: 8 10 2018
Statut: ppublish

Résumé

Scientific data on the image modality to be used in postcurative treatment surveillance of non-small cell lung cancer patients are scarce. This prospective randomized pilot trial compared the performance of integrated After termination of curative-intent treatment, patients were randomly assigned to the PET-CT or the CE-CT group. Imaging was performed every 6 months for 2 years. If suspicious radiologic findings were detected or patients became symptomatic, a diagnostic workup was initiated. Sensitivity, specificity, and positive predictive value for detecting cancer recurrence were calculated for both imaging procedures. The study enrolled 96 patients. In 14 of 50 patients (28%) in the PET-CT group and in 14 of 46 patients (30%) in the CE-CT group, a suspicious radiologic finding was confirmed as cancer recurrence after diagnostic workup. False-positive findings were detected in 11 patients (22%) of the PET-CT group and in 8 patients (17%) of the CE-CT group. The sensitivity, specificity, and positive predictive value for detecting cancer recurrence (95% confidence interval) were 0.88 (0.62 to 0.98), 0.62 (0.42 to 0.79), and 0.56 (0.35 to 0.76) for PET-CT and 0.93 (0.68 to 1.00), 0.72 (0.53 to 0.87), and 0.64 (0.41to 0.83) for CE-CT, respectively. The results of our study suggest that PET-CT is not superior to CE-CT in detecting cancer recurrence during 2 years after curative-intent treatment of non-small cell lung cancer.

Sections du résumé

BACKGROUND
Scientific data on the image modality to be used in postcurative treatment surveillance of non-small cell lung cancer patients are scarce. This prospective randomized pilot trial compared the performance of integrated
METHODS
After termination of curative-intent treatment, patients were randomly assigned to the PET-CT or the CE-CT group. Imaging was performed every 6 months for 2 years. If suspicious radiologic findings were detected or patients became symptomatic, a diagnostic workup was initiated. Sensitivity, specificity, and positive predictive value for detecting cancer recurrence were calculated for both imaging procedures.
RESULTS
The study enrolled 96 patients. In 14 of 50 patients (28%) in the PET-CT group and in 14 of 46 patients (30%) in the CE-CT group, a suspicious radiologic finding was confirmed as cancer recurrence after diagnostic workup. False-positive findings were detected in 11 patients (22%) of the PET-CT group and in 8 patients (17%) of the CE-CT group. The sensitivity, specificity, and positive predictive value for detecting cancer recurrence (95% confidence interval) were 0.88 (0.62 to 0.98), 0.62 (0.42 to 0.79), and 0.56 (0.35 to 0.76) for PET-CT and 0.93 (0.68 to 1.00), 0.72 (0.53 to 0.87), and 0.64 (0.41to 0.83) for CE-CT, respectively.
CONCLUSIONS
The results of our study suggest that PET-CT is not superior to CE-CT in detecting cancer recurrence during 2 years after curative-intent treatment of non-small cell lung cancer.

Identifiants

pubmed: 30292847
pii: S0003-4975(18)31358-4
doi: 10.1016/j.athoracsur.2018.08.015
pii:
doi:

Substances chimiques

Radiopharmaceuticals 0
Fluorodeoxyglucose F18 0Z5B2CJX4D

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

430-435

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Franco Gambazzi (F)

Clinic of Thoracic Surgery, Cantonal Hospital Aarau, Aarau, Switzerland. Electronic address: franco.gambazzi@ksa.ch.

Lukas D Frey (LD)

Institute of Nuclear Medicine and PET-Center, Cantonal Hospital Aarau, Aarau, Switzerland.

Matthias Bruehlmeier (M)

Institute of Nuclear Medicine and PET-Center, Cantonal Hospital Aarau, Aarau, Switzerland.

Wolf-Dieter Janthur (WD)

Clinic of Oncology, Cantonal Hospital Aarau, Aarau, Switzerland.

Sereina M Graber (SM)

Anthropological Institute and Museum, University of Zurich-Irchel, Zurich, Switzerland.

Juerg Heuberger (J)

Clinic of Radio-Oncology, Cantonal Hospital Aarau, Aarau, Switzerland.

Oliver S Springer (OS)

Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.

Roland Zweifel (R)

Institute of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland.

Bettina Boerner (B)

Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.

Gabrielo M Tini (GM)

Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.

Sarosh Irani (S)

Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.

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