¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

Abstract

Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC.

Computer-aided classification of lung nodules on computed tomography images via deep learning technique

“…Small lung nodules are regarded infrequently malignant, difficult to biopsy or excise, and not reliably characterized by positron emission tomography scan. 2 In clinical practice, the American College of Chest Physicians has published a guideline for the diagnosis and management of pulmonary nodules. 3 In this expert consensus-based recommendation, small nodules less than 8 mm could be further surveyed, characterized, or kept under observation according to evidence-based risk estimation.…”

Αξιολόγηση της PET/CT scan σε συνδυασμό με MRI εγκεφάλου, ως μοναδικού τρόπου σταδιοποίησης του μn - μικροκυτταρικού καρκίνου του πνεύμονα

“…στάδια για την ταξινόμηση του καρκίνου), ίσως είναι σημαντικό να εφαρμοστεί ένας ευρύτερος ορισμός σε μία οικονομική αξιολόγηση. Στην περίπτωση της ορθής σταδιοποίησης ως μέτρο της αποτελεσματικότητας της CT θώρακα ή της PET/CT, όσο πιο λεπτομερή είναι τα στάδια, τόσο μεγαλύτερος είναι ο πληθυσμός της μελέτης που χρειάζεται για να παράγει σημαντικά αποτελέσματα51 .…”