Increasingly, evidence of safety, effectiveness and cost-effectiveness is required to support funding of new diagnostic technologies. However, diagnostic imaging is a rapidly changing speciality with new data constantly being added to the evidence base. This article aims to review the evidence base for the application of fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) in lung cancer and to identify areas in which the evidence base is evolving. Currently, there is strong evidence for [18F]FDG-PET in characterisation of pulmonary nodules when there is a relative contra-indication for needle biopsy or when biopsy results are indeterminate, and for staging patients with non-small cell lung cancer without enlarged mediastinal lymph nodes on computed tomography (CT). Evidence is emerging for a role in patients undergoing radiotherapy but the impact on outcomes and cost-effectiveness is unknown. For patients with small cell lung cancer, [18F]FDG-PET can change clinical management but cost-effectiveness is yet to be evaluated is this patient group. PET/CT is more accurate than PET alone but it is unclear how this technology can be most effectively and cost-effectively incorporated into management pathways. The potential impact of quantitative contrast-enhanced CT on the cost-effectiveness of [18F]FDG-PET in characterisation of pulmonary nodules illustrates the need for continual re-evaluation of the evidence base as new techniques emerge.

Author

K A Miles

Contact Details

Corresponding address:
Division of Clinical and Laboratory Investigation,
Brighton & Sussex Medical School,
University of Sussex,
Falmer,
Brighton,
BN1 9PX, UK.

E-mail: k.a.miles@bsms.ac.uk

Reference

ICIS Cancer Imaging Volume 4 Special Issue B
DOI: 10.1102/1470-7330.2004.0032

Date Posted

3 January 2005

Print PDF

Size

3.72 MB

Minimum Estimated Download Times

ADSL 2Mb/s (Broadband):	14 seconds
ADSL 512Kb/s (Broadband):	59 seconds
64 Kb/s (ISDN):	7 minutes 56 seconds
33.3 Kb/s (Typical Modem):	15 minutes 15 seconds

Screen PDF

Size

240.40 KB

Minimum Estimated Download Times

ADSL 2Mb/s (Broadband):	1 second
ADSL 512Kb/s (Broadband):	3 seconds
64 Kb/s (ISDN):	30 seconds
33.3 Kb/s (Typical Modem):	57 seconds

No part of this publication or site may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the Publisher, e-MED Limited, Permissions, PO Box 61053, London, SE16 7YZ. Tel: +44 (0)207 719 8989 Fax: +44 (0)560 126 4446, permissions@cancerimaging.org.