Prospective use of serial questionnaires to evaluate the therapeutic efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in suspected lung cancer
Prospective use of serial questionnaires to evaluate the therapeutic efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in suspected lung cancer
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DOI：
10.1136/thorax.58.1.47
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发表时间：
2003-01-01
期刊：
影响因子：
10
通讯作者：
Smit, EF
中科院分区：
文献类型：
--
作者：
Herder, GJ;van Tinteren, H;Smit, EF
背景：一项研究旨在研究 F-18-氟脱氧葡萄糖 (FDG) 正电子发射断层扫描 (PET) 对临床上有问题的疑似非小细胞肺癌 (NSCLC) 患者的诊断和治疗的影响。方法：对 1997 年 8 月至 1999 年 7 月期间转诊接受 PET 的所有 164 名患者（大学/社区环境）进行前瞻性前后研究。 仅限于非侵入性检测未能解决临床问题的病例。使用问卷评估对诊断理解和管理的影响（不进行 PET 的预期治疗、PET 后的实际治疗选择、事后临床评估）。 结果：诊断问题尤其与不明确的放射学检查结果 (n= 112; 63%)、纵隔分期 (n=36; 20%) 和远处分期问题 (n= 16; 9%) 有关。 PET 结果通过审查医疗记录得到验证。 PET 对 84% 的诊断理解产生积极影响。据报道，仅基于 PET 的诊断理解提高了 26%。据转诊医生称，PET 使治疗效果发生了 50% 的有益变化。取消手术是 PET 后最常见的治疗变化（35%）。 结论：FDG PET 作为“附加”技术应用于患有这些临床问题的患者似乎是一种临床上有用的工具，直接改善了 25% 患者的治疗选择。 PET 扫描带来的置信度增加的价值需要进一步评估。
Background: A study was undertaken to study the effect of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the diagnosis and management of clinically problematic patients with suspected non-small cell lung cancer (NSCLC).Methods: A prospective before-after study was performed in a cohort of all 164 patients (university/community settings) referred for PET between August 1997 and July 1999. PET was restricted to cases where non-invasive tests had failed to solve clinical problems. The impact on diagnostic understanding and management was assessed using questionnaires (intended treatment without PET, actual treatment choice after PET, post hoc clinical assessment).Results: Diagnostic problems especially pertained to unclear radiological findings (n= 112; 63%), mediastinal staging (n=36; 20%), and distant staging issues (n= 16; 9%). PET findings were validated by reviewing medical records. PET had a positive influence on diagnostic understanding in 84%. Improved diagnostic understanding solely based on PET was reported in 26%. According to referring physicians, PET resulted in beneficial change of treatment in 50%. Cancelled surgery was the most frequent change in treatment after PET (35%).Conclusion: FDG PET applied as "add on" technology in patients with these clinical problems appears to be a clinically useful tool, directly improving treatment choice in 25% of patients. The value of increased confidence induced by PET scanning requires further evaluation.