18F-Fluorodeoxyglucose Positron Emission TomographyComputed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

Abstract EN

Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC).

Material and Methods.

Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC.

All patients were examined using PET/CT with intravenous contrast medium.

Those with disease stage ≤IIB underwent surgery ( n = 40 ).

Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately.

63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery.

The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis.

Results.

Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%.

For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively.

Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY).

Conclusion.

In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC.