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dc.contributor.authorLee, S Ten
dc.contributor.authorBerlangieri, Salvatore Uen
dc.contributor.authorPoon, A M Ten
dc.contributor.authorMitchell, Paul L Ren
dc.contributor.authorPathmaraj, Ken
dc.contributor.authorTabone, Ken
dc.contributor.authorByrne, Amanda Jen
dc.contributor.authorO'Keefe, Graeme Jen
dc.contributor.authorKnight, Simon Ren
dc.contributor.authorClarke, C Peteren
dc.contributor.authorScott, Andrew Men
dc.identifier.citationInternal Medicine Journal 2007; 37(11): 753-9en
dc.description.abstractAccurate staging of lung cancer is essential in determining the most appropriate management plan, as detection of occult metastasis can significantly alter management.The aims of this study are to determine the prevalence of occult metastasis in patients undergoing 2-(18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET) for evaluation of suspected/proven lung carcinoma and correlate pre-PET TNM stage with prevalence of metastasis.FDG-PET, which identified patients with metastasis on institutional database, was re-evaluated by a nuclear medicine physician blinded to clinical information. The confidence level of metastasis was scored on a 5-point scale, with a score of >/=4 considered positive.There were 67 of 645 (10%) patients identified with suspected occult metastasis on FDG-PET. Twelve patients scoring </=3 were excluded. Prevalence of occult metastasis was 10/156 (6%) in solitary pulmonary nodules (SPN); 22/319 (7%) and 23/170 (14%) in proven and suspected lung cancer, respectively. Positive predictive value of FDG-PET for metastasis was 8/10 (80%) in solitary pulmonary nodules, 14/20 (70%) and 17/21 (81%) in proven and suspected lung cancer, respectively. (18)F-FDG-avid lesions classified as false positives were patients with cholelithiasis, rib fractures and those with equivocal/negative bone scans or computed tomography on follow up. There was a higher incidence of true positive occult metastasis in patients in all stages of disease, particularly stage III disease.(18)F-FDG PET is predictive for occult metastatic disease in patients with solitary pulmonary nodules and proven or suspected lung cancer and is more likely to be present in all stages, particularly in stage III. PET findings should be actively pursued with correlative investigation to identify benign pathology in patients who remain candidates for curative treatment.en
dc.subject.otherAged, 80 and overen
dc.subject.otherFluorodeoxyglucose F18.diagnostic useen
dc.subject.otherLung Neoplasms.epidemiology.pathology.radionuclide imagingen
dc.subject.otherMiddle Ageden
dc.subject.otherNeoplasm Metastasis.radionuclide imagingen
dc.subject.otherNeoplasm Stagingen
dc.subject.otherPositron-Emission Tomographyen
dc.subject.otherPredictive Value of Testsen
dc.subject.otherRadiopharmaceuticals.diagnostic useen
dc.subject.otherRetrospective Studiesen
dc.subject.otherSolitary Pulmonary Nodule.epidemiology.pathology.radionuclide imagingen
dc.titlePrevalence of occult metastatic disease in patients undergoing 18F-FDG PET for primary diagnosis or staging of lung carcinoma and solitary pulmonary nodules.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternal Medicine Journalen
dc.identifier.affiliationCentre for Positron Emission Tomography, and Department of Medicine, University of Melbourne, and Ludwig Institute for Cancer Research, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Articleen, Salvatore U
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.languageiso639-1en- Haematology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Imaging and Therapy- Surgery- Imaging and Therapy- Newton-John Cancer Research Institute-
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