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Impact of 18 F‐fluorodeoxyglucose positron emission tomography in the staging and treatment response assessment of extra‐pulmonary small‐cell cancer
Author(s) -
Gregory DL,
Brennan SM,
Stillie A,
Herschtal A,
Hicks RJ,
MacManus MP,
Ball DL
Publication year - 2010
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2010.02146.x
Subject(s) - medicine , positron emission tomography , nuclear medicine , stage (stratigraphy) , fluorodeoxyglucose , radiology , radiation therapy , cancer staging , standardized uptake value , cancer , paleontology , biology
Summary The aim of this study was to retrospectively evaluate the value of 18 F‐fluorodeoxyglucose (FDG) positron emission tomography (PET) in extrapulmonary small‐cell cancer (EPSCC). Patients with EPSCC who underwent PET for staging or response assessment between 1996 and 2007 were identified from a database. Patient records were reviewed. PET‐based, and conventional staging and restaging results were compared. The binary staging classification of limited disease (LD) versus extensive disease (ED) was used. Patients with LD had tumours that could be encompassed within a tolerable radiation therapy (RT) volume. Of 33 eligible patients, 12 had staging PET scans, 11 had restaging scans and 10 had both. All known gross disease sites were FDG‐avid. PET and conventional stage groupings were concordant in 21 of 22 cases. One patient was appropriately upstaged from LD to ED by PET. PET detected additional disease sites, without causing upstaging in three further patients. Restaging PET scans identified previously unrecognised persistent or progressive disease in 4 of 21 cases. In four further cases, persistent FDG uptake after treatment was either false positive ( n = 2) or of uncertain ( n = 2) aetiology. PPV was 100% for staging and 82% for restaging. In 8 of 43 imaging episodes (19%), PET appropriately influenced management in five cases by changing treatment intent from radical to palliative, and in three cases by altering the RT volume. PET has incremental value compared to conventional imaging for staging EPSCC, and may also be useful for restaging after therapy. PET influenced patient management in 19% of 43 imaging episodes.