The Impact of Positron Emission Tomography on Clinical Decision Making in a University-Based Multidisciplinary Lung Cancer Practice

CHEST Journal ◽  
2005 ◽  
Vol 128 (2) ◽  
pp. 698-703 ◽  
Author(s):  
Sharona Sachs ◽  
Thomas V Bilfinger
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Positron Emission Tomography ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Emission Tomography ◽  
Positron Emission ◽  
The Impact

Impact of Positron Emission Tomography on Clinical Decision Making

CHEST Journal ◽  
2006 ◽  
Vol 130 (1) ◽  
pp. 300-301
Author(s):  
Gustavo A. Heresi ◽  
Peter J. Mazzone ◽  
James K. Stoller
Keyword(s):  
Decision Making ◽  
Positron Emission Tomography ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Emission Tomography ◽  
Positron Emission

Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer

2005 ◽  
Vol 23 (28) ◽  
pp. 6846-6853 ◽  
Author(s):  
Didier Lardinois ◽  
Walter Weder ◽  
Marina Roudas ◽  
Gustav K. von Schulthess ◽  
Michaela Tutic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Whole Body ◽  
Benign Tumors ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making

2008 ◽  
Vol 24 (02) ◽  
pp. 212-220 ◽  
Author(s):  
Raphaël Remonnay ◽  
Magali Morelle ◽  
Pascal Pommier ◽  
Francesco Giammarile ◽  
Marie-Odile Carrère
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Positron Emission Tomography ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Emission Tomography ◽  
Positron Emission ◽  
The Mean ◽  
Mean Cost ◽  
Radiotherapy Treatment

Objectives:Positron emission tomography (PET) is an innovative imaging tool. Associated with computed tomography (CT), it allows a better definition for the tumor volume for radiotherapy, compared with CT only. The aim of this study was to assess the effects of PET on resource allocation (costs and savings) and on the choice of the following treatment in radiotherapy.Methods:In 2004 and 2005, 209 patients were enrolled (97 patients with Hodgkin's disease and 112 with non-small cell lung cancer) in a national study conducted in eight hospitals. Two treatment decisions made on the basis of CT only or CT associated with PET, were compared in a prospective study where each subject was his/her own control. The direct medical cost of using PET was assessed by microcosting, using data collected from specific questionnaires. The costs of new tests and the costs and savings associated with changes in the chosen treatment were calculated on the basis of reimbursement rates.Results:The mean cost of using PET was approximately €800 per patient (50 percent for the radionuclide18F-FDG [2-[18F]fluoro-2-deoxy-D-glucose]). Radiotherapy treatments were modified for 10 percent of patients with Hodgkin's disease versus 40 percent of patients with lung cancer. Overall, the use of PET induced both increases and decreases in the mean cost per patient: the net effect was a €425 and €931 cost increase in lung cancer and Hodgkin's disease, respectively.Conclusions:The use of PET for radiotherapy decision making seems more valuable for lung cancer than for Hodgkin's disease, both in terms of costs and changes in radiotherapy treatment. This result might help policy makers for prioritization.

2-18fluoro-deoxy-D-glucose Positron Emission Tomography Is a Reliable Predictor for Viable Tumor in Postchemotherapy Seminoma: An Update of the Prospective Multicentric SEMPET Trial

2004 ◽  
Vol 22 (6) ◽  
pp. 1034-1039 ◽  
Author(s):  
Maria De Santis ◽  
Alexander Becherer ◽  
Carsten Bokemeyer ◽  
Franz Stoiber ◽  
Karin Oechsle ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clinical Decision Making ◽  
Residual Tumor ◽  
Clinical Decision ◽  
Emission Tomography ◽  
Clinical Value ◽  
Positron Emission ◽  
Residual Lesions

Purpose To define the clinical value of 2-18fluoro-deoxy-D-glucose positron emission tomography (FDG PET) as a predictor for viable residual tumor in postchemotherapy seminoma residuals in a prospective multicentric trial. Patients and Methods FDG PET studies in patients with metastatic pure seminoma who had radiographically defined postchemotherapy residual masses were correlated with either the histology of the resected lesion or the clinical outcome documented by computer tomography (CT), tumor markers, and/or physical examination during follow-up. The size of the residual lesions on CT, either > 3 cm or ≤ 3 cm, was correlated with the presence or absence of viable residual tumor. Results Fifty-six FDG PET scans of 51 patients were assessable. All 19 cases with residual lesions > 3 cm and 35 (95%) of 37 with residual lesions ≤ 3 cm were correctly predicted by FDG PET. The specificity, sensitivity, positive predictive value, and negative predictive value of FDG PET were 100% (95% CI, 92% to 100%), 80% (95% CI, 44% to 95%), 100%, and 96%, respectively, versus 74% (95% CI, 58% to 85%), 70% (95% CI, 34% to 90%), 37%, and 92%, respectively, for CT discrimination of the residual tumor by size (> 3 cm/≤ 3 cm). Conclusion This investigation confirms that FDG PET is the best predictor of viable residual tumor in postchemotherapy seminoma residuals and should be used as a standard tool for clinical decision making in this patient group.

Sign in / Sign up

Export Citation Format

Share Document