Abstract
Purpose: The purpose of this study was to prospectively evaluate the use of total-body FDG-PET scan (tbPET) as a single imaging modality in staging newly diagnosed lung cancer. Method: Fourteen patients (11M, 3F) with newly diagnosed primary lung cancer were prospectively studied. All patients underwent CT scan of chest ana upper abdomen, CT scan of the head, bone scan and tbPET. Diagnosis of primary lung cancer was established by bronchoscopy (11) and TTNA (3). Histology demonstrated non-small cell ca (13) and small cell ca (1). TNM and clinical stage (CS) was determined pre and post tbPET. Surgical staging (SS) was performed in 7/14 patients (thoracotomy 6, soft tissue biopsy (stb) 1). Results: In 7/14 patients there was discordance between pre and post PET TNM stage. CS was significantly changed in 2 patients (1,2), insignificant change in 2 patients (3,4) and no change in 3 patients (5,6,7). In addition, PET detected clinically unsuspected brain metastases in 3 patients. TbFET identified all M1 disease and primary lung cancer and changed the clinical management in 35% (5/14) of patients. Table 1 No TNM Stage C S SS Pre-Pet Post-Pet Pre- Post Pet -Pet 1 T1N2M1 T1N0M0 IV I I 2 T2N2M0 T2N2M1 IIIA IV IV 3 T2N0M0 T2N1M0 I II I 4 T1N0M0 T1N1M0 I II I 5 T3N0M1 T3N0M1 IV IV - 6 T2N0M1 T2N2M1 IV IV - 7 T2N0M1 T2N2M1 IV IV - Conclusion: TbPET had a significant impact on clinical management in 35% of patients. Clinical Implications: As a single imagine modality, tbPET can be a useful tool in staging lung cancer with significant impact on clinical management. Funding: Supported by Nebraska Research of Cancer and Smoking Disease Pilot Project Grant #288098-83500-120.