|ECR 2019 / C-3273|
|Significant extra-thoracic findings on PET-CT imaging for lung cancer patients in a tertiary centre: indentification and adequate management pathway|
The use of PET-CT in the management of cancer patients is on the increase due to its recommended use by the Department of Health and National Institute of Clinical Excellence (NICE). As widespread clinical application increases, identification of unexpected findings are not uncommon. These incidental findings are often suspicious for a second primary malignancy.
There are more than 40,000 new cases of lung cancer in the UK each year and more than 35,000 people die from the condition; more than for breast cancer and colorectal cancer combined. Lung cancer is now the leading cause of cancer death. The NICE guidelines advise that 18-fludeoxyglucose (FDG) PET should be used to differentiate between benign and malignant lung lesions where anatomical imaging or biopsy are inconclusive or biopsy is contraindicated and for staging of non-small cell lung cancer prior to radical treatment. During routine reporting of PET-CT scans, it is common to find areas of increased FDG uptake that are unlikely to be related to the neoplasm for which the patient is being scanned. Investigating into these findings may cause delays in the management of the primary malignancy as they require further investigations and may not be very popular with the referring clinicians, however, early diagnosis and treatment of a potential second malignancy picked up by these scans is undoubtedly necessary for overall management of these patients with known or possible lung cancers. The aims of this study were to assess the frequency of incidental findings on PET-CT scans performed for the lung cancer patients in our institution, whether appropriate follow up or investigation plan was suggested and also whether in such cases the patients were actually followed up according to recommendation to gain insight into the current management pathway and reveal any scopes of improvement.