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Clinical Value of Surveillance 18F-fluorodeoxyglucose PET/CT for Detecting Unsuspected Recurrence or Second Primary Cancer in Non-Small Cell Lung Cancer after Curative Therapy

1
Department of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul 04401, Korea
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Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
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Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
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Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
5
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
*
Author to whom correspondence should be addressed.
Academic Editor: Leonardo Pace
Cancers 2022, 14(3), 632; https://doi.org/10.3390/cancers14030632
Received: 11 November 2021 / Revised: 25 January 2022 / Accepted: 25 January 2022 / Published: 27 January 2022
(This article belongs to the Section Cancer Causes, Screening and Diagnosis)
Non-small cell lung cancer (NSCLC) patients are at considerable risk of recurrence or second primary cancer (SPC) after curative therapy. The utility of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) surveillance to detect recurrent lesions in NSCLC patients without suspicion of recurrence has not been established. The aim of our retrospective study was to evaluate the diagnostic value of surveillance FDG PET/CT for detecting clinically unsuspected recurrence or SPC in patients with NSCLC after curative therapy. In a cohort of 2684 NSCLC patients after curative therapy, surveillance FDG PET/CT showed good diagnostic efficacy for detecting clinically unexpected recurrence or SPC. Furthermore, the diagnostic performance was improved in subgroups of patients with advanced stage prior to curative therapy, PET/CT scans performed within 3 years after curative-intent therapy, and curative surgery. Surveillance PET/CT can be more useful when performed soon after therapy in curative surgery recipients and those with an advanced disease stage considering its diagnostic efficacy and yield.
We evaluated the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT surveillance for detecting clinically unsuspected recurrence or second primary cancer (SPC) in patients with non-small cell lung cancer (NSCLC) after curative therapy. A total of 4478 surveillance FDG PET/CT scans from 2864 NSCLC patients without suspicion of recurrence after curative therapy were reviewed retrospectively. In 274 of 2864 (9.6%) patients, recurrent NSCLC or SPC was found by surveillance PET/CT during clinical follow-up. Surveillance PET/CT scans showed sensitivity of 98.9% (274/277), specificity of 98.1% (4122/4201), accuracy of 98.2% (4396/4478), positive predictive value (PPV) of 77.6% (274/353), and negative predictive value of 99.9% (4122/4125). The specificity and accuracy in the curative surgery group were significantly higher than those in the curative radiotherapy group. PPV was significantly improved in subgroups of patients with advanced stage prior to curative therapy, PET/CT scans performed within 3 years after curative-intent therapy, and curative surgery. FDG PET/CT surveillance showed good diagnostic efficacy for detecting clinically unexpected recurrence or SPC in NSCLC patients after curative therapy. It can be more useful when performed soon after therapy in curative surgery recipients and those with an advanced disease stage considering its diagnostic efficacy and yield. View Full-Text
Keywords: non-small cell lung cancer; 18F-fluorodeoxyglucose; PET/CT; surveillance; recurrence; second primary cancer non-small cell lung cancer; 18F-fluorodeoxyglucose; PET/CT; surveillance; recurrence; second primary cancer
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MDPI and ACS Style

Lim, C.H.; Park, S.B.; Kim, H.K.; Choi, Y.S.; Kim, J.; Ahn, Y.C.; Ahn, M.-j.; Choi, J.Y. Clinical Value of Surveillance 18F-fluorodeoxyglucose PET/CT for Detecting Unsuspected Recurrence or Second Primary Cancer in Non-Small Cell Lung Cancer after Curative Therapy. Cancers 2022, 14, 632. https://doi.org/10.3390/cancers14030632

AMA Style

Lim CH, Park SB, Kim HK, Choi YS, Kim J, Ahn YC, Ahn M-j, Choi JY. Clinical Value of Surveillance 18F-fluorodeoxyglucose PET/CT for Detecting Unsuspected Recurrence or Second Primary Cancer in Non-Small Cell Lung Cancer after Curative Therapy. Cancers. 2022; 14(3):632. https://doi.org/10.3390/cancers14030632

Chicago/Turabian Style

Lim, Chae Hong, Soo Bin Park, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Yong Chan Ahn, Myung-ju Ahn, and Joon Young Choi. 2022. "Clinical Value of Surveillance 18F-fluorodeoxyglucose PET/CT for Detecting Unsuspected Recurrence or Second Primary Cancer in Non-Small Cell Lung Cancer after Curative Therapy" Cancers 14, no. 3: 632. https://doi.org/10.3390/cancers14030632

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