The management impact of clinically significant incidental lesions detected on staging FDG PET-CT in patients with non-small cell lung cancer (NSCLC): An analysis of 649 cases

Lin, Michael; Ambati, Chaitanya

doi:10.1016/j.lungcan.2011.11.024

Cited by 14 publications

(2 citation statements)

References 17 publications

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“…Approximately 30% of focal FDG uptake can be indicative of malignancy, whereas a diffuse pattern of FDG uptake usually indicates a benign cause. In the findings of one study, FDG PET/CT identified a second primary malignancy or premalignant lesion in 3% of patients with NSCLC, a finding that changed management from a curative intent to palliation in 27% of patients (56).…”

Section: Detection Of a Second Primary Malignancymentioning

confidence: 99%

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

et al. 2018

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Lung cancer is the leading cause of cancer-related mortality in the United States, and accurate staging plays a vital role in determining prognosis and treatment. The recently revised eighth edition of the TNM staging system for lung cancer defines new T and M descriptors and updates stage groupings on the basis of substantial differences in survival. There are new T descriptors that are based on the findings at histopathologic examination, and T descriptors are reassigned on the basis of tumor size and extent. No changes were made to the N descriptors in the eighth edition of the TNM staging of lung cancer, because the four N categories that are based on the location of the diseased nodes can be used to consistently predict prognosis. The eighth edition includes a new M1b descriptor for patients with a single extrathoracic metastatic lesion in a single organ (M1b), because they have better survival and different treatment options, compared with those with multiple extrathoracic lesions (M1c). Examination with fluorine 18 fluorodeoxyglucose (FDG) PET/CT is the standard of care and is an integral part of the clinical staging of patients with lung cancer. To provide the treating physicians with accurate staging information, radiologists and nuclear medicine physicians should be aware of the updated classification system and should be cognizant of the site-specific strengths and limitations of FDG PET/CT. In this article, the eighth edition of the TNM staging system is reviewed, as well as the role of FDG PET/CT in the staging of non-small cell lung carcinoma. ©

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Section: Detection Of a Second Primary Malignancymentioning

confidence: 99%

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

et al. 2018

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“…This can result in a vast array of unexpected findings remote from the primary region of abnormality and interest. Incidental second primary malignancies, reported in up to 3.1% of PET/CT, are suspected when focal increased metabolic activity is detected in a location unusual for metastatic spread of the patient's known malignancy, and when not interpreted as a physiological site of uptake . Traditional medicine encourages the formulation of a single, unifying diagnosis, however, multiple comorbidities frequently exist in oncology patients, including both benign and malignant causes, with a higher prevalence of synchronous or metachronous malignancy compared with the healthy .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of non ¹⁸F‐fluorodeoxyglucose‐avid incidental findings of clinical significance on whole body positron emission tomography/computed tomography: A review of 500 consecutive cases

et al. 2017

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Returning Incidental Research Findings From ¹⁸F‐Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography to Participants: A Survey of Investigators From a Clinical Trial of Rheumatoid Arthritis

Kang,

Andrews,

Giles

et al. 2024

Arthritis Care & Research

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ObjectiveThere are limited data on researchers’ attitudes and beliefs on returning and managing incidental research findings from whole body 18F‐fluorodeoxyglucose–positron emission tomography/computed tomography (FDG PET/CT) imaging.MethodsSite principal investigators (PIs) who enrolled participants for the Treatments Against Rheumatoid Arthritis and Effect on FDG PET/CT (TARGET) trial were surveyed.ResultsOf the 28 TARGET site PIs eligible for the study, 18 consented to participate (response rate: 64%). Many site PIs returned incidental findings to participants (61%), and the most common finding that was returned was serious (but not life‐threatening) and treatable (54.5%). More than half of the investigators believed that adequacy of clinical follow up (58.8%) and legal liability if incidental findings are not disclosed (55.6%) were extremely important factors in returning incidental research findings from whole body FDG PET/CT. All investigators felt very obligated to return incidental research findings if scans revealed a treatable, high‐risk medical condition. Most investigators felt very obligated to disclose incidental findings with important health implications (94.4%), for which proven preventive or therapeutic interventions exist (77.8%), that provide early detection of a health problem (72.2%), if participants ask for their incidental findings (72.2%), and if scans have established validity for a particular medical condition (61.1%).ConclusionAlthough it is recommended that researchers report and manage incidental research findings, our data show differing views and uncertainties on what and how to return, and the extent of follow up needed to manage, incidental findings from whole body FDG PET/CT; this highlights the need for more specific and standardized guidance.

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The management impact of clinically significant incidental lesions detected on staging FDG PET-CT in patients with non-small cell lung cancer (NSCLC): An analysis of 649 cases

Cited by 14 publications

References 17 publications

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

Prevalence of non ¹⁸F‐fluorodeoxyglucose‐avid incidental findings of clinical significance on whole body positron emission tomography/computed tomography: A review of 500 consecutive cases

Returning Incidental Research Findings From ¹⁸F‐Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography to Participants: A Survey of Investigators From a Clinical Trial of Rheumatoid Arthritis

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The management impact of clinically significant incidental lesions detected on staging FDG PET-CT in patients with non-small cell lung cancer (NSCLC): An analysis of 649 cases

Cited by 14 publications

References 17 publications

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non–Small Cell Lung Cancer

Prevalence of non 18F‐fluorodeoxyglucose‐avid incidental findings of clinical significance on whole body positron emission tomography/computed tomography: A review of 500 consecutive cases

Returning Incidental Research Findings From 18F‐Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography to Participants: A Survey of Investigators From a Clinical Trial of Rheumatoid Arthritis

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Prevalence of non ¹⁸F‐fluorodeoxyglucose‐avid incidental findings of clinical significance on whole body positron emission tomography/computed tomography: A review of 500 consecutive cases

Returning Incidental Research Findings From ¹⁸F‐Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography to Participants: A Survey of Investigators From a Clinical Trial of Rheumatoid Arthritis