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Am J Nucl Med Mol Imaging 2013;3(5):408-416
Original Article
PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage
I non-small-cell lung cancer
Bari Dane, Vadim Grechushkin, April Plank, William Moore, Thomas Bilfinger
New York University Langone Medical Center, 550 First Avenue, New York, NY, USA; Department of Radiology, Stony Brook University
Hospital, Stony Brook, NY, USA
Received March 5, 2013; Accepted July 22, 2013; Epub September 19, 2013; Published September 30, 2013
Abstract: 18F-FDG PET/CT was compared with non-contrast chest CT in monitoring for recurrence 1-year after lobectomy of stage 1
non-small-cell lung cancer (NSCLC). For surveillance after treatment with curative intent, current (April 2012) National
Comprehensive Cancer network guidelines recommend chest CT with or without contrast every 6-12 months for 2 years, then
non-contrast chest CT annually. PET/CT is not currently indicated for routine follow-up. One hundred patients receiving surveillance
PET/CT 1-year after lobectomy for the treatment of stage 1a or 1b NSCLC were included in the study. Exclusion criteria included the
presence or interval diagnosis of a second malignancy, or surgical treatment more radical than single lobectomy. The non-contrast
CT obtained from the 1-year PET/CT was interpreted by an experienced chest radiologist blinded to the PET/CT for evidence of
recurrence using the following findings: pulmonary nodule, pleural effusion, pleural mass, adenopathy, and extrathoracic mass. The
decision about recurrence was made solely from the non-contrast CT without PET/CT findings. This was compared with the
determination made with PET/CT. The reference standard for determination of recurrence was the multi-disciplinary tumor board
who had access to all imaging and clinical data. Recurrence at 1 year was documented in 16 of 90 patients. All 16 recurrences were
documented with PET/CT and 9 were found with non-contrast CT. Five of the 7 recurrences missed with non-contrast CT were
extrathoracic metastases. Sensitivity of CT and PET/CT for recurrence was 56.3% and 100%, respectively (p = 0.015). Specificity of
CT and PET/CT for recurrence was 95.9% and 93.2%, respectively (p = 0.62). (ajnmmi1303002).
Keywords: Lung cancer, PET/CT, non-small cell, CT, lobectomy, stage 1, lung cancer surveillance
Address correspondence to: William Moore, Department of Radiology, Stony Brook Hospital, HSC level 4 Room 120, 100 Nicolls
Rd, Stony Brook, NY 11794, USA. Tel: 631-638-2121; Fax: 631-444-7538; E-mail: william.moore@stonybrook.edu
Original Article
PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage
I non-small-cell lung cancer
Bari Dane, Vadim Grechushkin, April Plank, William Moore, Thomas Bilfinger
New York University Langone Medical Center, 550 First Avenue, New York, NY, USA; Department of Radiology, Stony Brook University
Hospital, Stony Brook, NY, USA
Received March 5, 2013; Accepted July 22, 2013; Epub September 19, 2013; Published September 30, 2013
Abstract: 18F-FDG PET/CT was compared with non-contrast chest CT in monitoring for recurrence 1-year after lobectomy of stage 1
non-small-cell lung cancer (NSCLC). For surveillance after treatment with curative intent, current (April 2012) National
Comprehensive Cancer network guidelines recommend chest CT with or without contrast every 6-12 months for 2 years, then
non-contrast chest CT annually. PET/CT is not currently indicated for routine follow-up. One hundred patients receiving surveillance
PET/CT 1-year after lobectomy for the treatment of stage 1a or 1b NSCLC were included in the study. Exclusion criteria included the
presence or interval diagnosis of a second malignancy, or surgical treatment more radical than single lobectomy. The non-contrast
CT obtained from the 1-year PET/CT was interpreted by an experienced chest radiologist blinded to the PET/CT for evidence of
recurrence using the following findings: pulmonary nodule, pleural effusion, pleural mass, adenopathy, and extrathoracic mass. The
decision about recurrence was made solely from the non-contrast CT without PET/CT findings. This was compared with the
determination made with PET/CT. The reference standard for determination of recurrence was the multi-disciplinary tumor board
who had access to all imaging and clinical data. Recurrence at 1 year was documented in 16 of 90 patients. All 16 recurrences were
documented with PET/CT and 9 were found with non-contrast CT. Five of the 7 recurrences missed with non-contrast CT were
extrathoracic metastases. Sensitivity of CT and PET/CT for recurrence was 56.3% and 100%, respectively (p = 0.015). Specificity of
CT and PET/CT for recurrence was 95.9% and 93.2%, respectively (p = 0.62). (ajnmmi1303002).
Keywords: Lung cancer, PET/CT, non-small cell, CT, lobectomy, stage 1, lung cancer surveillance
Address correspondence to: William Moore, Department of Radiology, Stony Brook Hospital, HSC level 4 Room 120, 100 Nicolls
Rd, Stony Brook, NY 11794, USA. Tel: 631-638-2121; Fax: 631-444-7538; E-mail: william.moore@stonybrook.edu
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