Lung cancer is the commonest cancer with 1.3 million cases diagnosed every single year throughout the world. 1 NICE Lung Cancer guidelines in 2011strongly recommend performing a PET-CT scan in all patients being considered for radical treatment after a staging CT scan of the neck,
chest and liver has been performed. 2 If mediastinal lymphadenopathy is detected by CT scan and the aetiology is determined by intervention,
then the true value of PET-CT scan can be measured in the detection of...
Methods and materials
233 consecutive patients with suspected lung cancer and no known extrathoracic metastases were referred for a staging PET-CT scan prior to being subject to radical therapy were included. All patients underwent a standard whole body PET-CT scan and a contrast-enhanced neck,
chest and liver CT scan at the same attendance in the same scanner. The prior staging CT scans were reviewed in all the patients with non-nodal metastases detected on PET-CT scan to determine whether the metastasis was...
Characteristics of Study Group (n = 233) Median age at diagnosis: 73 years (±9.6; Range: 38 to 92 years) Sex: 139 men (60%) Median Interval between staging CT scan and PET-CT scan: All patients: 25 days (IQR,
18-29) Extrathoracic metastases: 22 (9%) of 233 patients had 25 extra-thoracic and extra-cerebral metastases 9 of the 25 metastases were identified on both the CT component of the PET-CT scan and on review of the prior staging CT 16 were not visible on the staging CT scan
The addition of pelvic CT scan in patients referred for PET-CT staging scan prior to radical therapy may allow for increased detection of extrathoracic metastases. PET-CT scan detects extrathoracic metastases which were missed or invisible on the staging CT scan. Lung cancer patients should be offered a contrast-enhanced staging CT scan of the neck,
abdomen and pelvis prior to the PET-CT scan. Potentially,
an interval CT scan should be performed if a delay of greater than 30 days has...
Oxford University Hospitals NHS Trust,
UK. E-mail: firstname.lastname@example.org
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