PET-CT and the staging of SSNs
Research type
Research Study
Full title
The utility of PET-CT in the staging of patients with presumed lung cancer manifesting as a sub-solid lung nodule.
IRAS ID
228227
Contact name
John Curtin
Contact email
Sponsor organisation
Research and Development Office
Duration of Study in the UK
0 years, 3 months, 30 days
Research summary
Current guidance from the National Institute of Clinical Excellence (NICE) suggests that all patients with a suspected lung cancer that are potentially suitable for treatment with curative intent should be offered a PET-CT before treatment. PET-CT can help to identify nodal and more distant disease that was not demonstrated on the staging CT study in non small cell lung cancers.
It is widely reported that cancers that manifests as a sub-solid nodules (SSNs) frequently produces a false negative result on PET-CT (i.e. they are frequently not FDG avid). Only a few retrospective studies have addressed the question of whether PET-CT provides useful additional information with regards to pre-operative staging in patients with cancer manifesting as a SSN. These studies have suggested that PET-CT adds little value over the initial staging CT study.
PET-CT is an expensive test that involves a significant radiation dose, so avoiding its use in cases where it is unlikely to help would be beneficial to both the patient and the health service.
Our study will retrospectively review PET-CT cases from the Norfolk & Norwich University Hospital PACS image archive and corresponding data found in the Norfolk and Norwich University Hospital pathology database (ICE). The primary aim will be to assess the sensitivity/specificity of PET-CT as a test in the assessment of local nodal disease in cases of presumed cancer arising from a SSN. The PET-CT reports will be compared to surgical histopathology results obtained following lobectomy (the gold standard). We will also record the incidence of metastatic disease as reported on the PET/CT scans. A secondary aim will be assess the utility of PET-CT in the characterisation of SSNs as either benign or malignant. This study will add to the growing body of evidence relating to the use of PET-CT in the characterisation of SSNs, evidence that will most likely have a bearing on future national and international guidance relating to the management of lung nodules.
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
17/WM/0242
Date of REC Opinion
16 Jun 2017
REC opinion
Favourable Opinion