Franco Gambazzi1, Lukas D Frey2, Matthias Bruehlmeier2, Wolf-Dieter Janthur3, Sereina M Graber4, Juerg Heuberger5, Oliver S Springer6, Roland Zweifel7, Bettina Boerner8, Gabrielo M Tini8, Sarosh Irani8. 1. Clinic of Thoracic Surgery, Cantonal Hospital Aarau, Aarau, Switzerland. Electronic address: franco.gambazzi@ksa.ch. 2. Institute of Nuclear Medicine and PET-Center, Cantonal Hospital Aarau, Aarau, Switzerland. 3. Clinic of Oncology, Cantonal Hospital Aarau, Aarau, Switzerland. 4. Anthropological Institute and Museum, University of Zurich-Irchel, Zurich, Switzerland. 5. Clinic of Radio-Oncology, Cantonal Hospital Aarau, Aarau, Switzerland. 6. Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland. 7. Institute of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland. 8. Clinic of Pulmonary and Sleep Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.
Abstract
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 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and contrast-enhanced computed tomography (CE-CT). 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.
RCT Entities:
BACKGROUND: Scientific data on the image modality to be used in postcurative treatment surveillance of non-small cell lung cancerpatients are scarce. This prospective randomized pilot trial compared the performance of integrated 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and contrast-enhanced computed tomography (CE-CT). 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.
Authors: Beverley L Høeg; Pernille E Bidstrup; Randi V Karlsen; Anne Sofie Friberg; Vanna Albieri; Susanne O Dalton; Lena Saltbæk; Klaus Kaae Andersen; Trine Allerslev Horsboel; Christoffer Johansen Journal: Cochrane Database Syst Rev Date: 2019-11-21