The Role of the (18)F-Fluorodeoxyglucose-Positron Emission Tomography Scan in the Nederlands Leuvens Longkanker Screenings Onderzoek Lung Cancer Screening Trial
| Autor: | Harry J. de Koning, Rob J. van Klaveren, Harry J.M. Groen, Carla Weenink, René M. Vernhout, Willem P.Th.M. Mali, Frederik B. Thunnissen, Jan-Willem J. Lammers, Matthijs Oudkerk, Kristiaan Nackaerts, Susan C. van't Westeinde |
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| Přispěvatelé: | Pathology, CCA - Oncogenesis, Pulmonary Medicine, Public Health, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
RECRUITMENT medicine.medical_specialty Positron emission tomography Population SPIRAL COMPUTED-TOMOGRAPHY STANDARDIZED UPTAKE VALUES Preoperative care Pulmonary nodule Benign nodule DOSE CT SDG 3 - Good Health and Well-being DESIGN MANAGEMENT Medicine education Lung cancer PULMONARY NODULES Survival rate Mass screening POPULATION education.field_of_study medicine.diagnostic_test business.industry Cancer F-18-FDG UPTAKE PET scan medicine.disease Thoracic surgery PET Oncology Radiology business Nuclear medicine Lung cancer screening |
| Zdroj: | Journal of Thoracic Oncology, 6(10), 1704-1712. International Association for the Study of Lung Cancer Westeinde, S C, Koning, H J, Thunnissen, F B J M, Oudkerk, M, Groen, H J, Lammers, J W, Weenink, C, Vernhout, R, Nackaerts, K, Mali, W & van Klaveren, RJ 2011, ' The Role of the (18)F-Fluorodeoxyglucose-Positron Emission Tomography Scan in the Nederlands Leuvens Longkanker Screenings Onderzoek Lung Cancer Screening Trial ', Journal of Thoracic Oncology, vol. 6, no. 10, pp. 1704-1712 . https://doi.org/10.1097/JTO.0b013e3182286d0b Journal of Thoracic Oncology, 6(10), 1704-1712. ELSEVIER SCIENCE INC |
| ISSN: | 1556-0864 |
| Popis: | Background: In computed tomography lung cancer screening programs, up to 30% of all resections are futile.Objective: To investigate whether a preoperative positron emission tomography (PET) after a conclusive or inconclusive nonsurgical workup will reduce the resection rate for benign disease in test-positive participants of a lung cancer screening program.Methods: (18) F-Fluorodeoxyglucose-PET scans were made in 220 test positives. Nodules were classified as positive, indeterminate, or negative based on visual comparison with background activity. Gold standard for a positive PET was the presence of cancer in the resection specimen or the detection of cancer during more than 2 years follow-up. Sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated at participant level and 95% confidence intervals (CIs) constructed.Results: The sensitivity of PET to detect cancer was 84.2% (95% CI: 77.6-90.7%), the specificity 75.2% (95% CI: 67.1-83.3), the positive predictive value 78.9% (95% CI: 71.8-86.0), and the NPV 81.2% (95% CI: 73.6-88.8). The resection rate for benign disease was 23%, but 26% of them had a diagnosis with clinical consequences. A preoperative PET after an inconclusive nonsurgical workup reduced the resection rate for benign lesions by 11 to 15%, at the expense of missing 12 to 18% lung cancer cases. A preoperative PET after a conclusive nonsurgical workup reduced the resection rate by 78% at the expense of missing 3% lung cancer cases.Conclusion: A preoperative PET scan in participants with an inconclusive nonsurgical workup is not recommended because of the very low NPV, but after a conclusive nonsurgical workup, the resection rate for benign disease can be decreased by 72%. |
| Databáze: | OpenAIRE |
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