Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Follow up of indeterminate lung nodules on PET-CT  scan in patient with lung cancer treated with curative intent : Retrospective study (#209)

Pawan Bajaj 1 , Kathleen Houston 1
  1. Medical Oncology , Nambour General Hospital , Nambour , QLD, Australia

Introduction:  Indeterminate pulmonary nodule in patients with lung cancer is common clinical problem. Lung cancer screening studies of smokers at high risk for malignancy report  prevalence of pulmonary nodules as high as 50 percent with  epidemiological studies reporting a prevalence of incidental nodules identified on CT at 31 percent [1]. FDG-PET has diagnostic accuracy of 91% in patient with lung cancer [2]. Approximately 50% of indeterminate lung nodules for which surgery is performed for diagnosis are benign [3].


Material and Method: We retrospectively reviewed patients with stage I- III lung cancer treated at Tertiary Hospital from 2012-2014. Patients were identified through MDT  from   2012-2014. We followed subsequent imaging with CT of all patients with indeterminate lung nodules.


Results:  We identified 31 patients with biopsy proven lung cancer who had indeterminate lung nodules based on PET/CT review in multidisciplinary meeting.  Almost half (49%) of patients had stage I disease, 11(35%) patients have stage II disease and 5 (16 %) patients have stage III disease.  None of patients in our study had N 3 disease. 25 patients (80 %) underwent curative surgical resection. Majority of lung nodules (60%) deemed non-significant were between 6- 10 mm and 2 patients had lung nodules between 10-15 mm.  4 (12%) patients were lost to follow up or care was transferred to another facility.  Only 3 (9%) nodules deemed non-significant grew on follow up CT scans and all 3 patients has stage III disease.  1 patient out of 3 patients did not have any other disease apart, rest 2 developed metastatic disease.

Conclusion: Majority of lung nodules (91%) identified on PET/CT and reviewed in lung multi-disciplinary meeting did not progress on surveillance Imaging with CT scan.  This is small retrospective study at single centre and we did not review SUV uptake on PET scan.

  1. 1. Recent Trends in the Identification of Incidental Pulmonary Nodules. Gould MK, Tang T, Liu IL, Lee J, Zheng C, Danforth KN, Kosco AE, Di Fiore JL Am J Respir Crit Care Med. 2015 Nov;192(10):1208-14. 2. Positron emission tomography in the diagnosis and staging of lung cancer: a systematic, quantitative review. Fischer BM, Mortensen J, Højgaard Lancet Oncol. 2001;2(11):659. 3. Mack MJ, Hazelrigg SR, Landreneau RJ, Acuff TE. Thoracoscopy for the diagnosis of the indeterminate solitary pulmonary nodule. Ann Thorac Surg 1993; 56:825-830.