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Positron Emission Tomography in the Staging of Small-Cell Lung Cancer^*

A Preliminary Study

^* From the Department of Internal Medicine (Drs. Hauber, Meyer, and Pforte), the Department of Nuclear Medicine (Dr. Bohuslavizki), the Department of Radiology (Dr. Lund), and the Department of Endoscopy (Dr. Fritscher-Ravens), University Hospital Eppendorf, Hamburg, Germany.

Correspondence to: Hans-Peter Hauber, MD, Department of Internal Medicine, Pulmonology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; e-mail: hhauber{at}uke.uni-hamburg.de

Study objectives: Small-cell lung cancer (SCLC) has an unfavorable prognosis, especially when the disease is extensive at presentation. Accurate staging procedures are therefore needed for treatment planning. Positron emission tomography (PET) is a modern noninvasive imaging technique, the value of which for the staging of SCLC was investigated in the present study.

Setting: University hospital.

Patients: Thirty-one patients with suspected lung cancer were investigated for staging purposes using chest radiography, CT of the thorax and abdomen, abdominal ultrasound, and bone scanning. Twenty-five patients also received PET examinations during the staging procedures. Five of these patients were found to have SCLC, while two patients had mixed lesion types. Further analysis of the latter group was carried out.

Results: PET detected the primary tumor in all patients, and lymph nodes in five patients. All lymph nodes were proved to be malignant by endoscopic ultrasonography-guided fine-needle aspiration. Only one patient had distant metastases, which were detected by both CT and PET.

Conclusions: PET appears be a suitable imaging method in SCLC. A potential role for the technique as a standard staging procedure will need to be tested by investigating a larger number of patients in a prospective study.

Key Words: extensive disease • limited disease • metastases • positron emission tomography • prognosis • small-cell lung cancer • staging

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