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| Albrecht Kretzschmar is a
board-certified medical oncologist and has passed the European Society for Medical Oncology (ESMO) examination. He is
currently the senior consultant for gastrointestinal oncology at the HELIOS-Klinikum Berlin-Buch.
His fields of interest are
multicentre clinical trials in solid tumours including carcinoma of unknown primary site and
supportive care. He is a member of the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO) and the German Society
of Haematology and Oncology (DGHO), as well as Arbeitsgemeinschaft Internistische Onkologie (AIO; German Medical Oncologists Working Group). He specialised in internal medicine and haematology and oncology at the University of Heidelberg, Germany and the Charité, Berlin. |
Should integrated PET/CT be used for thoracic lesions? A critical appraisal
Albrecht Kretzschmar and
Peter C. Thuss-Patience
Departments of Medicine, Haematology, Medical Oncology and Tumour-Immunology, HELIOS-Klinikum Berlin, Robert-Rössle-Klinik of the Universitätsmedizin Berlin, Charité, Campus Berlin Buch.
Address for correspondence:
Albrecht Kretzschmar
HELIOS-Klinikum Berlin
Robert-Rössle-Klinik
D-13122 Berlin, Germany
Tel: +49 30 9417 1316 Fax: +49 30 9417 1219
Email: akretzschmar@berlin.helios-kliniken.de
Abstract
Integrated positron emission tomography-computed tomography (PET/CT) is an innovative imaging test offering the potential for a higher degree of accuracy and sensitivity compared with plain radiographic
investigations. It was shown that PET/CT might enable differentiation of benign from malignant lesions
without histology in the majority of cases. From a
conservative point of view, a new diagnostic tool that is expensive and exposes the patient to radiation should be used routinely only if this test was shown, by the highest level of evidence, to meet certain criteria.
That is, the test must be cost-effective, spare other costly or potentially harming investigations, spare
therapeutic strategies that are of no value to the patients, or contribute to better patient management resulting in improved outcome (i.e. survival) or quality of life. Unfortunately none of these claims can be answered completely with regard to the use of PET/CT in thoracic lesions. Therefore, PET/CT should be employed mainly in the setting of prospective trials
and should not be used widely as standard procedure
in the work-up of thoracic lesions.
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