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Annals of Oncology Advance Access originally published online on October 23, 2006
Annals of Oncology 2007 18(2):338-345; doi:10.1093/annonc/mdl374
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© 2006 European Society for Medical Oncology

lung cancer

A prospective study of PET/CT in initial staging of small-cell lung cancer: comparison with CT, bone scintigraphy and bone marrow analysis

BM Fischer1,*, J Mortensen1, SW Langer2, A Loft1, AK Berthelsen1, BL Petersen3, G Daugaard2, U Lassen2 and HH Hansen2

1 Department of Nuclear Medicine and PET
2 Department of Oncology
3 Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark

* Correspondence to: Dr B. M. Fischer, Research Fellow, Department of Nuclear Medicine and PET, Copenhagen University Hospital, 4012 Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-39563550; Fax: +45-35453898; E-mail: malene.fischer{at}rh.dk

Background: Small-cell lung cancer (SCLC) accounts for 15%–20% of all lung cancer cases. Accurate and fast staging is mandatory when choosing treatment, but current staging procedures are time consuming and lack sensitivity.

Patients and methods: A prospective study was designed to examine the role of combined positron emission tomography/computed tomography (PET/CT) compared with standard staging (CT, bone scintigraphy and immunocytochemical assessment of bone marrow biopsy) of patients with SCLC. Thirty-four consecutive patients were included. Twenty-nine patients received initial PET/CT.

Results: PET/CT caused change of stage in 5/29 (17%). Excluding patients with unconfirmed findings or pleural effusion, the sensitivity for accurate staging of patients with extensive disease was the following: for standard staging 79%, PET 93% and PET/CT 93%. Specificity was 100%, 83% and 100%, respectively.

Conclusion: The results from this first study on PET/CT in SCLC indicates that PET/CT can simplify and perhaps even improve the accuracy of the current staging procedure in SCLC. A larger clinical trial, preferably with consequent histological confirmation in case of discordance, however, is warranted.

Key words: bone marrow, bone scintigraphy, diagnostic accuracy, PET/CT, small-cell lung cancer, staging

Received for publication April 28, 2006. Revision received August 22, 2006. Accepted for publication August 30, 2006.


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