Abstract
Objective: [18F]Fluorodeoxyglucose positron emission tomography-computerized tomography (PET-CT) scan is a tool widely used in the diagnosis and staging of lung cancer. Referral bias is present when the results of a diagnostic study affect the decision to proceed with definitive testing. This bias artificially increases the sensitivity and decreases the specificity, and may inappropriately alter the decision to undergo definitive testing. The accuracy of PET-CT scan in suspected lung cancer and the role of referral bias were investigated. Methods: From January 2005 through June 2007, 584 consecutive patients undergoing PET-CT scan for suspected lung cancer were studied. Endpoints measured included qualitative and quantitative results of PET-CT scans and pathologic results from patients, who underwent invasive procedures for diagnosis, staging and/or therapy. A positive PET scan was defined as one in which the standard uptake value (SUV) was greater than 2.5. A standard mathematical model, based on overall results of PET-CT scan in all patients, was used to create adjustments to account for the effect of referral bias. Results: A total of 414 (71%) of PET-CT scans were reported as positive, while 170 (29%) were negative. Attempt at tissue diagnosis occurred in 417 patients (71%); surgical intervention was performed in 246 (42%). Whereas 86% (355/414) of patients with a positive PET-CT scan underwent tissue sampling, only 36% (62/170) with a negative PET-CT scan had an attempt (p
| Original language | English (US) |
|---|---|
| Pages (from-to) | 560-564 |
| Number of pages | 5 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 39 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2011 |
| Externally published | Yes |
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Keywords
- Diagnostic accuracy
- Lung cancer
- Oncology
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
- Medicine(all)
Cite this
[18F]Fluorodeoxyglucose positron emission tomography-computerized tomography and lung cancer : A significant referral bias exists. / Okereke, Ikenna; Gangadharan, Sidhu P.; Kent, Michael S.; Nicotera, Saila P.; DeCamp, Malcolm M.
In: European Journal of Cardio-thoracic Surgery, Vol. 39, No. 4, 04.2011, p. 560-564.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - [18F]Fluorodeoxyglucose positron emission tomography-computerized tomography and lung cancer
T2 - A significant referral bias exists
AU - Okereke, Ikenna
AU - Gangadharan, Sidhu P.
AU - Kent, Michael S.
AU - Nicotera, Saila P.
AU - DeCamp, Malcolm M.
PY - 2011/4
Y1 - 2011/4
N2 - Objective: [18F]Fluorodeoxyglucose positron emission tomography-computerized tomography (PET-CT) scan is a tool widely used in the diagnosis and staging of lung cancer. Referral bias is present when the results of a diagnostic study affect the decision to proceed with definitive testing. This bias artificially increases the sensitivity and decreases the specificity, and may inappropriately alter the decision to undergo definitive testing. The accuracy of PET-CT scan in suspected lung cancer and the role of referral bias were investigated. Methods: From January 2005 through June 2007, 584 consecutive patients undergoing PET-CT scan for suspected lung cancer were studied. Endpoints measured included qualitative and quantitative results of PET-CT scans and pathologic results from patients, who underwent invasive procedures for diagnosis, staging and/or therapy. A positive PET scan was defined as one in which the standard uptake value (SUV) was greater than 2.5. A standard mathematical model, based on overall results of PET-CT scan in all patients, was used to create adjustments to account for the effect of referral bias. Results: A total of 414 (71%) of PET-CT scans were reported as positive, while 170 (29%) were negative. Attempt at tissue diagnosis occurred in 417 patients (71%); surgical intervention was performed in 246 (42%). Whereas 86% (355/414) of patients with a positive PET-CT scan underwent tissue sampling, only 36% (62/170) with a negative PET-CT scan had an attempt (p
AB - Objective: [18F]Fluorodeoxyglucose positron emission tomography-computerized tomography (PET-CT) scan is a tool widely used in the diagnosis and staging of lung cancer. Referral bias is present when the results of a diagnostic study affect the decision to proceed with definitive testing. This bias artificially increases the sensitivity and decreases the specificity, and may inappropriately alter the decision to undergo definitive testing. The accuracy of PET-CT scan in suspected lung cancer and the role of referral bias were investigated. Methods: From January 2005 through June 2007, 584 consecutive patients undergoing PET-CT scan for suspected lung cancer were studied. Endpoints measured included qualitative and quantitative results of PET-CT scans and pathologic results from patients, who underwent invasive procedures for diagnosis, staging and/or therapy. A positive PET scan was defined as one in which the standard uptake value (SUV) was greater than 2.5. A standard mathematical model, based on overall results of PET-CT scan in all patients, was used to create adjustments to account for the effect of referral bias. Results: A total of 414 (71%) of PET-CT scans were reported as positive, while 170 (29%) were negative. Attempt at tissue diagnosis occurred in 417 patients (71%); surgical intervention was performed in 246 (42%). Whereas 86% (355/414) of patients with a positive PET-CT scan underwent tissue sampling, only 36% (62/170) with a negative PET-CT scan had an attempt (p
KW - Diagnostic accuracy
KW - Lung cancer
KW - Oncology
UR - http://www.scopus.com/inward/record.url?scp=79952537022&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952537022&partnerID=8YFLogxK
U2 - 10.1016/j.ejcts.2010.07.039
DO - 10.1016/j.ejcts.2010.07.039
M3 - Article
C2 - 20833060
AN - SCOPUS:79952537022
VL - 39
SP - 560
EP - 564
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 4
ER -