Feature | April 01, 2014

Pre-operative PET Cuts Unnecessary Lung Surgeries in Half

Pre-operative PET Lung Surgeries Nuclear Imaging Clinical Study

April 1, 2014 — New quantitative data suggests that 30 percent of the surgeries performed for non-small cell lung cancer patients in a community-wide clinical study were deemed unnecessary. Additionally, positron emission tomography (PET) was found to reduce unnecessary surgeries by 50 percent, according to research published in the March issue of the Journal of Nuclear Medicine.

PET imaging prior to surgery helps stage a patient's disease by providing functional images of tumors throughout the body, especially areas where cancer has spread, otherwise known as metastasis. Few studies have been able to pin down exactly what impact preoperative PET has on clinical decision-making and resulting treatment. Preliminary review of the data from this long-term, observational study of an entire community of veterans was inconclusive about the utility of PET, but after a more thorough statistical analysis accounting for selection bias and other confounding factors, the researchers were able to conclude that PET imaging eliminated approximately half of unnecessary surgeries.

"It has become standard of care for lung cancer patients to receive preoperative PET imaging," said Steven Zeliadt, Ph.D., lead author of the study conducted at VA Puget Sound Health Care System and associate professor for the University of Washington in Seattle, Wash. "The prevailing evidence reinforces the general understanding within the medical community that PET is very useful for identifying occult metastasis and that it helps get the right people to surgery while avoiding unnecessary surgeries for those who would not benefit."

For this study, researchers reviewed newly diagnosed non-small lung cancer patients who received preoperative PET to assess the real-life effectiveness of PET as a preventative measure against unnecessarily invasive treatment across a community of patients. A total of 2,977 veterans who underwent PET during disease staging from 1997 to 2009 were included in the study. Of these, 976 patients underwent surgery to resect their lung cancer. During surgery or within 12 months of surgery, 30 percent of these patients were found to have advanced-stage metastatic disease, indicating an unnecessary surgery.

Interestingly, the use of PET increased during the study period from 9 to 91 percent. Conventional multivariate analyses was followed by instrumental variable analyses to account for unobserved anomalies, such as when patients did not undergo PET when it would have been clinically recommended to do so. This new data has the potential to change policy and recommendations regarding the use of oncologic PET for more accurate tumor staging.

"We will likely build more quality measures around this research so that preoperative PET is more strongly recommended to improve the management of care for these patients," added Zeliadt.

For more information: www.snmmi.org

 

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
RSNA 2017 technical exhibits, expo floor, showing new radiology technology advances.
Feature | RSNA 2017 | January 11, 2018
January 11, 2018 — Here is a list of some of the key clinical study presentations, articles on trends and videos from
Hip Steroid Injections Associated with Bone Changes

58-year-old woman with left hip pain. X-ray from one month prior to the steroid/anesthetic injection demonstrates moderate joint space narrowing (arrows) and bony proliferation (arrowheads).

News | Orthopedic Imaging | January 11, 2018
January 11, 2018 – Osteoarthritis patients who received a steroid injection in the hip had a significantly greater in
Overlay Init