(18)F-fluorodeoxyglucose positron-emission tomography-computed tomography to diagnose recurrent cancer

Sometimes the diagnosis of recurrent cancer in patients with a previous malignancy can be challenging. This prospective cohort study assessed the clinical utility of (18)F-fluorodeoxyglucose positron-emission tomography-computed tomography ((18)F-FDG PET-CT) in the diagnosis of clinically suspected...

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Bibliographic Details
Published in:British journal of cancer 2015-05, Vol.112 (11), p.1737-1743
Main Authors: You, J J, Cline, K J, Gu, C-S, Pritchard, K I, Dayes, I S, Gulenchyn, K Y, Inculet, R I, Dhesy-Thind, S K, Freeman, M A, Chan, A M, Julian, J A, Levine, M N
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Canada
Female
Fluorodeoxyglucose F18
Humans
Male
Middle Aged
Multimodal Imaging
Neoplasm Recurrence, Local - diagnostic imaging
Neoplasm Recurrence, Local - pathology
Neoplasms - diagnostic imaging
Neoplasms - pathology
Positron-Emission Tomography - methods
Radiography
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Summary:Sometimes the diagnosis of recurrent cancer in patients with a previous malignancy can be challenging. This prospective cohort study assessed the clinical utility of (18)F-fluorodeoxyglucose positron-emission tomography-computed tomography ((18)F-FDG PET-CT) in the diagnosis of clinically suspected recurrence of cancer. Patients were eligible if cancer recurrence (non-small-cell lung (NSCL), breast, head and neck, ovarian, oesophageal, Hodgkin's or non-Hodgkin's lymphoma) was suspected clinically, and if conventional imaging was non-diagnostic. Clinicians were asked to indicate their management plan before and after (18)F-FDG PET-CT scanning. The primary outcome was change in planned management after (18)F-FDG PET-CT. Between April 2009 and June 2011, 101 patients (age, median 65 years; 55% female) were enroled from four cancer centres in Ontario, Canada. Distribution by primary tumour type was: NSCL (55%), breast (19%), ovarian (10%), oesophageal (6%), lymphoma (6%), and head and neck (4%). Of the 99 subjects who underwent (18)F-FDG PET-CT, planned management changed after (18)F-FDG PET-CT in 52 subjects (53%, 95% confidence interval (CI), 42-63%); a major change in plan from no treatment to treatment was observed in 38 subjects (38%, 95% CI, 29-49%), and was typically associated with (18)F-FDG PET-CT findings that were positive for recurrent cancer (37 subjects). After 3 months, the stated post-(18)F-FDG PET-CT management plan was actually completed in 88 subjects (89%, 95% CI, 81-94%). In patients with suspected cancer recurrence and conventional imaging that is non-diagnostic, (18)F-FDG PET-CT often provides new information that leads to important changes in patient management.
ISSN:1532-1827
DOI:10.1038/bjc.2015.151