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K. Purbhoo
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-026 - 18F-FDG PET/CT Evaluation of Non-Small Cell Lung Cancer - Initial Experience from Johannesburg (ID 63)
09:30 - 17:00 | Author(s): K. Purbhoo
- Abstract
Background:
Lung cancer is the most common cause of cancer-related mortality, with an overall five year survival of 16.6%. It is most likely to recur in the first four years after therapy. The overall five year survival for newly diagnosed lung cancer is poor in both developed and developing countries. In South Africa, statistics show that lung cancer caused 52,217 deaths between 1995 and 2006. The 2009 data from South Africa showed that the number of male and female cases of lung cancer was 1440 and 685, respectively. [18]F-FDG PET/CT allows non-invasive imaging of non-small cell lung cancer (NSCLC) based on the increased glucose metabolism by the cancer cells. [18]F-FDG PET/CT imaging of NSCLC has been found to be useful in staging, early detection of recurrence, detection of residual disease and monitoring of treatment response. Our study was carried out to evaluate its role in histologically proven NSCLC in our center.
Methods:
We retrospectively reviewed data of 34 patients with histologically confirmed NSCLC. A total of 51 scans were reviewed, of which 17 were follow-up PET/CT scans. Eleven patients had 1 follow up (FU) scan, 5 patients had 2 FU scans and one patient had 3 FU scans. FDG-PET/CT findings were reported as positive or negative for disease. Sites for distant and nodal metastases were noted. Follow up scans were also compared with previous or base line scans to assess for treatment response, early detection of recurrence and detection of residual disease. Of the total number of patients, only 24 patients have had follow up to see how PET/CT influenced their management.
Results:
Data were analysed from 20 males (59%) and 14 females (41%) of which majority (83%) were aged between 61 to 80 years old. A total of 51 scans were done, 37 (72.5%) were positive and 14 (27.5%) were negative. Almost a quarter of PET/CT scans were referred for staging (25.3%), about half for detection of residual disease (47.1%) and the remaining for the detection of recurrence (13.8%) and assessment of treatment response (13.8%). At initial imaging, metastases were visualized in 44% of patients; two-thirds of the metastases being in the adrenal, bone and contralateral lung. Nodal disease on the initial scans was noted in 56% of patients. We compared the findings in patients with FU studies. The changes from the initial studies and the first FU showed a tendency towards a significant difference (p=0.05; Pearson Chi-square). When the rest of FU scans were compared, there was no significant difference (p=0.66 for FU1 Vs FU2) and (p=0.71 for FU2 Vs FU3). PET/CT correctly up staged 29.4% and down stage 5.9% of patients and at the same time falsely down staged 5.9% and upstaged 2.9% of patients.
Conclusion:
[18]F-FDG PET/CT is useful in staging, early detection of recurrence, detection of residual disease and monitoring of treatment response in patients with non-small cell cancer. The tendency noted in comparing the initial and FU scans is due to lower power of this study.
