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Radiology Research and Practice
Volume 2014, Article ID 135934, 12 pages
http://dx.doi.org/10.1155/2014/135934
Clinical Study

18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

1Department of Radiology, Research Institute La Princesa, La Princesa University Hospital, C/Diego de León 62, 28006 Madrid, Spain
2Health Technology Assessment Unit, Lain Entralgo Agency, C/Gran Vía 27, 28013 Madrid, Spain
3National School of Health, Sinesio Delgado 4, 28029 Madrid, Spain
4Institute for Health and Consumer Protection, Joint Research Centre, European Commission, Via E. Fermi 2749, 21027 Ispra, Italy

Received 11 June 2014; Revised 26 September 2014; Accepted 1 October 2014; Published 5 November 2014

Academic Editor: Paul Sijens

Copyright © 2014 Nieves Gómez León et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC.