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FDG-PET should be a 'preferred method' for the evaluation of tumor behavior in lung cancer, US radiologists say.

FDG-PET should be a "preferred method" for the evaluation of tumor behavior in lung cancer, US radiologists say [1].

Presenting evidence to suggest that FDG uptake by stage I lung tumors "accurately predicts the rate of future growth of the cancer," they professed: "This finding may help individualize treatment in those in whom the risk versus benefit of aggressive therapy is not clear cut."

The research group looked at data from 55 patients diagnosed with stage I lung cancer, all of whom had undergone one pre-treatment FDG-PET scan and two pre-treatment CT scans which were at least 25 days apart.

Twenty-two patients had rapid doubling times (less than 180 days) calculated on CT; 19 had doubling times between 180 and 270 days and ten had slow doubling times, of more than 270 days.

The authors reported "a significant relationship between growth rates, as measured by serial CT examinations, and the initial pre-treatment metabolic activities, as measured by FDG uptake."

They noted that CT evaluation of tumor growth has a number of advantages, including wide availability of CT scanners and low cost.

However, they added: "Delaying treatment so that one can observe the growth of a known lung cancer, even over this short interval [at least 25 days], is difficult to justify. Because FDG imaging requires a single examination that is performed in less than two hours, FDG-PET should be a preferred method to elucidate the behavior of the tumor."

[1] Can FDG-PET be used to predict growth of stage I lung cancer?
Clin Radiol 2008; 63: 856-863