Role of Whole Body 18F-FDG PET-CT Scan in Newly Diagnosed Lung Carcinoma Patients for Baseline Staging and Treatment Planning

Introduction : We compared the accuracy of staging by whole body coincidence mode 18F-FDG PET-CT scan with thoracic and abdominal computed tomography scan. Material and Methods : Histopathologically proven newly diagnosed 109 patients (in 12 months) of lung carcinoma underwent whole body (base of the skull to upper third of thigh) FDG PET scan and baseline thoracic and abdominal CT. Results : FDG PET changed the N stage in 36 (33%) patients and changed the M stage in 21 (19%) patients. In staging of mediastinal lymphnodes, 23 (21%) patients, which were inoperable by CT had surgically operable disease by PET and 13 (12%) patients who were operable by CT were detected to be inoperable by PET. Ten (9%) patients had metastases demonstrated by PET not found by CT and 11 (10%) patients labelled metastatic by CT did not show metastases by PET. Thus, 34 (31%) patients were downstaged by PET and thereby labelled as potentially operable and 23 (21%) patients were upstaged by PET, these patients received palliative therapies rather than more expensive radical treatments. Conclusion : 18F-FDG PET-CT scan plays an important role in baseline staging of lung carcinoma. It substantially influences the treatment planning and is also a cost-effective tool in the overall management of lung carcinoma.