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Annals of Oncology Advance Access published online on October 23, 2006
Annals of Oncology, doi:10.1093/annonc/mdl374
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© 2006 European Society for Medical Oncology
Received April 28, 2006
Revised August 22, 2006
Accepted August 30, 2006

original article

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

B. M. Fischer 1 *, J. Mortensen 1, S. W. Langer 2, A. Loft 1, A. K. Berthelsen 1, B. L. Petersen 3, G. Daugaard 2, U. Lassen 2, and H. H. Hansen 2

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

* To whom correspondence should be addressed.
B. M. Fischer, E-mail: malene.fischer{at}rh.dk


  Abstract

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.

Keywords: bone marrow; bone scintigraphy; diagnostic accuracy; PET/CT; small-cell lung cancer; staging.
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