Sammanfattning
BACKGROUND PET-CT is an aid in the assessment of lung cancer for identifying operable patients. The examination is recommended for most patients with non-small cell lung cancer whom the primary assessment has indicated may have a curable disease. The aim was to assess the usefulness of PET-CT for patients assumed to be operable who underwent an examination at Rikshospitalet.
MATERIAL AND METHOD Patients admitted for lung cancer assessment are registered consecutively in the department’s quality database. We analysed data for the period 2007 - 2011 for patients whom a primary assessment had revealed to have a potentially operable tumour. For capacity reasons, some patients underwent surgery without a prior PET-CT.
RESULTS Of 651 potentially operable patients, 533 had had a PET-CT scan of which 403 (76 %) had undergone surgery. We calculated that the examination had a sensitivity of 78 % (95 % CI 70 - 86) and specificity 88 % (95 % CI 85 - 91 %), positive predictive value 64 % (95 % CI 55 - 72) and negative predictive value 94 % (95 % CI 91 - 96) for spreading to mediastinal lymph nodes. Diagnostic accuracy was 86 % (95 % CI 83 - 89) with kappa agreement 0.61 (95 % CI 0.53 - 0.69) between PET-CT and actual findings of malignant or benign mediastinal lymph nodes.
INTERPRETATION PET-CT was a useful tool for selecting potentially operable lung cancer patients at Rikshospitalet in the period 2007 - 2011. Provided that the population we scan with PET-CT does not change, patients with a negative PET-CT can with few exceptions be referred directly for surgery without further invasive assessment.