Follow-up of indeterminate lung nodules on pet-ct scan in patient with lung cancer treated with curative intent: Retrospective study

Abstract

Introduction: Indeterminate pulmonary nodule in patients with lung cancer is a common clinical problem. Lung cancer screening studies of smokers at high risk for malignancy report prevalence of pulmonary nodules as high as 50% with epidemiological studies reporting a prevalence of incidental nodules identified on CT at 31%.1 FDG-PET has diagnostic accuracy of 91% in patient with lung cancer.2 Approximately 50% of indeterminate lung nodules for which surgery is performed for diagnosis are benign.3 Material and Method: We retrospectively reviewed patients with stage I-III lung cancer treated at Tertiary Hospital from 2012 to 2014. Patients were identified through MDT from 2012 to 2014. We followed subsequent imaging with CT of all patients with indeterminate lung nodules. Results: We identified 31 patients with biopsy proven lung cancer who had indeterminate lung nodules based on PET/CT review in multidisciplinary meeting. Almost half (49%) of patients had stage I disease, 11(35%) patients have stage II disease and five (16%) patients have stage III disease. None of the patients in our study had N 3 disease. 25 patients (80%) underwent curative surgical resection. Majority of lung nodules (60%) deemed nonsignificant were between 6 and 10 mm and two patients had lung nodules between 10 and 15 mm. 4 (12%) patients were lost to follow up or care was transferred to another facility. Only three (9%) nodules deemed nonsignificant grew on follow-up CT scans and all three patients have stage III disease. 1 patient out of three patients did not have any other disease apart, rest two developed metastatic disease. Conclusion: Majority of lung nodules (91%) identified on PET/CT and reviewed in lung multidisciplinary meeting did not progress on surveillance imaging with CT scan. This is small retrospective study at single center and we did not review SUV uptake on PET scan.L613440163 <br />