Lung cancer screening using low-dose CT and FDG-PET in liver transplant recipients
Meylin Caballeros Lam 1 , Paula Pujols 1 , Ana Ezponda Casajús 2 , Fernando Guillén Valderrama 3 , María José García Velloso 4 , Alejandra Wyss 5 , Loreto García Del Barrio 2 , Javier Larrache Latasa 2 , Jesús Pueyo Villoslada 2 , María Dolores Lozano Escario 6 , Juan Pablo de Torres Tajes 7 , Ana Belén Alcaide Ocaña 7 , Aránzazu Campo Ezquibela 7 , Luis Seijo Maceiras 8 , Luis Montuenga Badía 9 , Javier Zulueta 10 , Mercedes Iñarrairaegui Bastarrica 11 , Ignacio Herrero Santos 11 , Gorka Bastarrika Alemañ 2
Objective: To address the feasibility of implementing a lung cancer screening program in liver transplant recipients (LTR) targeted to detect early stage lung cancer.
Material and methods: 124 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 computed tomography (LDCT) and F-18-fluorodeoxyglycose positron emission tomography (FDG-PET) were analysed.
Results: Lung cancer was detected in 12 LTR (9.7%), most of which corresponded to non-small cell subtype. Two of the 12 lung cancers were detected on 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, positive and negative predictive values of FDG-PET to detect malignancy in our cohort were 81.8%,100%,99.3%, 100% and 99.3%, respectively.
Conclusion: A carefully followed multidisciplinary lung cancer screening algorithm in LTR, that includes FDG-PET and LDCT, allows lung cancer to be diagnosed at an early stage, while reducing unnecessary invasive procedures.
CITATION Liver Transpl. 2023 Mar 20. doi: 10.1097/LVT.0000000000000121