Positron emission tomography for staging XXXX : does it lead to a different therapeutic approach?

@entity1 @entity419 @entity5 @entity418 @entity3
Accurate preoperative staging is essential for the indication and selection of the appropriate surgical procedure in @entity1 with @entity418 . The present prospective study was designed to determine if the preoperative use of @entity419 positron emission tomography (FDG-PET) increases the accuracy of staging @entity418 compared with computed tomography (CT) and if it thereby leads to a different therapeutic approach. A total of 58 @entity1 , 46 @entity1 and 12 @entity1 (mean age 61 years), with histologic proof of @entity418 underwent FDG-PET of the neck, chest, and abdomen, as well as CT of the chest and abdomen, to determine @entity5 stage. FDG-PET and CT data were compared with each other and with pathohistologic findings. Sensitivity, specificity, and overall accuracy for detecting histologically verified lymph node and distant @entity3 were calculated for FDG-PET and CT. FDG-PET showed a higher specificity, whereas CT had higher accuracy for detecting both abdominal (73% vs. 59%) and thoracic (73% vs. 63%) lymph node @entity3 . The accuracy of detecting blood-borne and lymphatic distant @entity3 was identical for CT and FDG-PET imaging (50%). FDG-PET had a higher specificity than CT (87% vs. 13%) but lower sensitivity (35% vs. 67%). FDG-PET did not provide new information on the indication for surgery, nor was it helpful for choosing the appropriate surgical procedure in @entity1 with @entity418 . In view of the relatively high cost of FDG-PET examinations, the use of this modality is indicated primarily in @entity1 with inconclusive CT findings or for scientific research projects. Higher sensitivity as a result of @entity5 -affinity radiopharmaceuticals and optimized apparatus resolution, in addition to the advantages offered by whole-body PET scanning, may lead to new indications for this staging procedure in the future.
