4.5 Article

Lung cancer screening using low-dose CT and FDG-PET in liver transplant recipients

Journal

LIVER TRANSPLANTATION
Volume -, Issue -, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/LVT.0000000000000121

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In this study, a lung cancer screening program was implemented in liver transplant recipients (LTR) using low-dose CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET). The results showed that 9.7% of the LTR were diagnosed with lung cancer, most of which were non-small cell subtype. The majority of lung cancers (82.3%) were diagnosed at stage I, indicating the effectiveness of the screening program in detecting early-stage lung cancer.
To address the feasibility of implementing a lung cancer screening program in liver transplant recipients (LTR) targeted to detect early-stage lung cancer one hundred twenty-four LTR (89% male, 59.8+/-8.8 y old), who entered the lung cancer screening program at our hospital were reviewed. The results of the diagnostic algorithm using low-dose CT and F-18-fluorodeoxyglycose positron emission tomography (FDG-PET) were analyzed. Lung cancer was detected in 12 LTR (9.7%), most of which corresponded to the non-small cell subtype. Two of the 12 lung cancers were detected in the baseline study (prevalence of 1.6%), whereas 10 patients were diagnosed with lung cancer in the follow-up (incidence of 8.1%). Considering all cancers, 10 of 12 (83.3%) were diagnosed at stage I, one cancer was diagnosed at stage IIIA, and another one at stage IV. The sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values of F-18-fluorodeoxyglycose positron emission tomography to detect malignancy in our cohort were 81.8%,100%, 99.3%, 100%, and 99.3%, respectively. A carefully followed multidisciplinary lung cancer screening algorithm in LTR that includes F-18-fluorodeoxyglycose positron emission tomography and low-dose CT allows lung cancer to be diagnosed at an early stage while reducing unnecessary invasive procedures.

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