SESSION TYPE: Lung Cancer I
PRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AM
PURPOSE: Adjunctive technologies are used to evaluate radiographic lung lesions suspicious for lung cancers (LC) prior to invasive biopsies. 18-Fluoro-Deoxy-Glucose Positron-Emission-Tomography (PET) scan is often used to evaluate lung nodules and to stage LC. PET accuracy is dependent on lesion size, metabolic activity of cancers, and can be falsely positive in inflammation and infections. We have recently published (JThoracicOncol 2012;7:681) on the potential role of Transcutaneous Computed Bioconductance (CB) measurements as a non-invasive, non-radiating test for LC. This abstract compares the performance of CB Vs PET.
METHODS: Of the 41 subjects in the final CB analysis, 29 LC and 12 benign, 27 had concomitant PET. PET studies read as positive, negative or indeterminate (mild, possible inflammatory). A composite CB score is generated from measurements from 62 predetermined skin points, and result in either a positive or negative. The final diagnosis is according to tissue biopsy or long-term radiologic follow-up of stability to resolution.
RESULTS: Excluding 7 indeterminate PET readings, no LC cases were missed (sensitivity 100%(14/14)), with specificity 67%(4/6 true negative). However, including the 7 indeterminate readings, the PET sensitivity for LC drops to 78%(14/18); 2/4 missed LC were <1cm. For the CB test, direct comparison with 20 PET cases (positive or negative only, no indeterminate), sensitivity is 86%(12/14), specificity 83%(5/6 true negative). When including the 7 indeterminate PET readings, CB sensitivity and specificity improves to 88.9%(16/18) and 89%(8/9 true negative) respectively. Of the four LC indeterminate by PET, two were 8mm (resected adenoCa/BAC), two others were 18 and 48 mm and all four were positive by CB criteria.
CONCLUSIONS: CB performs favorably versus PET in assessment of CT-detected lesions in a prospective study, especially for PET-indeterminate lesions.
CLINICAL IMPLICATIONS: Results from NLST for LC screening and clinical chest CT will identify many suspicious lesions. Need for early LC diagnosis must be balanced against unnecessary biopsies and exposure to excessive ionization radiation during diagnostic studies (serial CT,PET-CT), CB measurement may be an useful risk-stratification technology prognostic of finding LC in such cases.
DISCLOSURE: Rex Yung: Grant monies (from industry related sources): funded study, Consultant fee, speaker bureau, advisory committee, etc.: consultancy to help develop multi center pivotal study
Mingying Zeng: Other: position at institution (JHU) partially funded by industry sponsored research
Michael Garff: Employee: salary
Karleen Callahan: Consultant fee, speaker bureau, advisory committee, etc.: study design and data base analysis related consultancy
Greg Stoddard: Consultant fee, speaker bureau, advisory committee, etc.: performed biostatistical analysis for study
This is a funded study that has been approved by the Institutional IRB (Johns Hopkins University) with funding directed by sponsor (FreshMedx) to the institution (JHU) conducting the research as a funded study contract.Johns Hopkins University, Baltimore, MD