Staging and managing lung tumors using F-18FDG coincidence detection

Purpose: Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomogr aphic (PET) imaging can be a vital tool in the evaluation and preoperative staging of pulmonary neoplasms, Imaging studies on the gamma camera using c oincidence PET (co-PET) were introduced recently into clinical practice. Th is prospective study assessed the efficacy of co-PET for identifying primar y tumors, mediastinal lymph node involvement, the presence of distant sprea d, the effect on disease staging, and influence on disease management, Patients and Methods: Sixty consecutive patients with 61 lung tumors were e nrolled in the study (36 men, 24 women; age range, 32-87 years; mean age, 6 7 years), Histopathologic confirmation was obtained in 58 patients (59 tumo rs). Results: In assessments of a primary lesion to establish its malignant or b enign nature, the sensitivity rate of co-PET was 96% (53 of 55 lesions), th e specificity rate was 83% (5 of 6 lesions), and the accuracy rate was 95% (58 of 61 lesions). In the co-PET assessment of lymph node involvement in w hich histopathologic confirmation was obtained (n = 32), the sensitivity ra te was 89% (8 of 9 lesions), the specificity rate was 91% (21 of 23 lesions ), and the accuracy rate was 91% (29 of 32 lesions), Previously unknown dis tant metastases were correctly identified in eight patients, but five false -positive lesions were detected in the brain. Disease staging was correctly altered in 20 patients (33%), and disease management plans were changed in 20 patients (33%) based on the co-PET findings, Unnecessary surgery was ob viated in six patients (10%). One patient was given the chance for curative treatment based on the findings of the co-PET study. Conclusion: The evaluation of patients with lung neoplasms using F-18 FDG c oincidence detection appears to be reliable.