Dr. Remge Pieterman and colleagues compared the standard method of detecting cancers throughout the body--which includes computed tomography (CT), ultrasound, bone scanning, and needle biopsies--to a newer technique called whole-body positron emission tomography (PET), in 102 patients with lung cancer. None of the patients had small-cell lung cancer, a form of the disease, which is more difficult to treat.
They found that PET was able to detect non-small-cell lung cancer and its spread with more sensitivity than the traditional methods. In 11 of 102 patients, PET detected secondary cancers that had not been found by the standard method.
"Our study confirms that, as compared with traditional staging methods, PET can result in a more accurate classification of the stage of disease in patients with...non-small-cell lung cancer," Pieterman's group writes in the July 27th issue of The New England Journal of Medicine.
Although they weren't looking specifically at whether the PET scan improved the chances of survival for the cancer patients, the researchers suggest that "the increased accuracy may improve survival."
They recommend that future studies examine survival in these patients. In the meantime, the researchers note that at present, the procedure is not cost effective due to the limited availability of the equipment needed to perform the scan.
In an accompanying editorial, Dr Salvatore Berlangieri and Dr Andrew Scott, both of Austin and Repatriation Medical Center, Melbourne, Australia note that many US insurers have approved reimbursement of PET for lung cancer. These results add to "the accumulating body of evidence that PET...is more accurate than CT" for lung cancer staging.
Lung cancer is the leading cause of cancer deaths in both men and women in the US and will claim about 160,000 lives in this year.
SOURCE: The New England Journal of Medicine 2000; 343; 254-261.