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

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.

CITA DEL ARTÍCULO  Liver Transpl. 2023 Mar 20.  doi: 10.1097/LVT.0000000000000121