Diagnostic and staging impact of radiotherapy planning FDG-PET-CT in non-small-cell lung cancer

Radiother Oncol. 2011 Nov;101(2):284-90. doi: 10.1016/j.radonc.2011.06.030. Epub 2011 Jul 23.


Background and purpose: To evaluate whether FDG-PET performed for radiotherapy (RT) planning can detect disease progression, compared with staging PET.

Materials and methods: Twenty-six patients with newly-diagnosed non-small-cell lung cancer underwent planning PET-CT for curative RT within 8 weeks (mean: 33±14days) of staging PET-CT. Progressive disease (PD) was defined as >25% increase in tumour size (transaxial) or volume, as delineated by SUV threshold of 2.5, or new sites (SUV>2.5).

Results: The planning PET detected PD in 16 patients (61%), compared to four patients (15%) by CT component of PET-CT. The mean scan interval was longer in patients with progression: 40±12days, compared to 22±11days without progression. Planning PET detected PD in 13/17 (76%), 12/14 (86%) and 7/7 patients if the interval was ≥4, 5 and 6 weeks, respectively, compared with 3/9 patients if interval <4 weeks. Planning PET detected PD in primary metabolic volume in seven patients, 20 new nodal sites in 12 new nodal stations and nine patients, five extra-nodal sites in five patients. This resulted in upstaging in nine patients (35%): stage IIIA in three, IIIB in three and IV in three.

Conclusions: RT-planning FDG-PET can provide incremental diagnostic information and may impact on staging in a significant number of patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Disease Progression
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Image Interpretation, Computer-Assisted
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Radiotherapy Planning, Computer-Assisted*
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Tumor Burden
  • Whole Body Imaging


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18