A trial looking at PET-CT targeted biopsy to diagnose cancer of the covering of the lungs (TARGET)

Cancer type:

Cancer spread to the lung

Lung cancer

Mesothelioma

Secondary cancers

Status:

Results

Phase:

Other

This trial looked at having a PET-CT scan to find the best place to take a sample of tissue (biopsy Open a glossary item ) from the lung.

It was for people who had already had at least one biopsy. But the results weren’t clear so they were due to have another one.

The trial was open for people to join between 2015 and 2018. The team published the results in 2024.

More about this trial

The covering of the lungs are called the pleura. Cancers that affect the pleura include:

pleural mesothelioma
lung cancer
other types of cancers that have spread to the covering of the lung

TARGET TRIAL - diagram of the lung showing the pleura

A chest x-ray Open a glossary item can sometimes show that the pleura has become thicker. This thickening is a possible sign of cancer. The doctor usually takes a sample (biopsy) of the tissue to see if it contains cancer cells. This biopsy might be guided by a CT scan. This is to make sure that the doctor takes the sample from the right place.

Sometimes the biopsy doesn’t show cancer cells or the result is not clear. But the doctor still suspects there is cancer in the pleura.

A PET-CT scan highlights areas where cells are more active. Cancer cells are usually more active than normal cells. So doctors thought that a PET-CT scan might be better at showing them the best place to take a biopsy.

Everyone taking part in the trial was put into a group at random:

half had the standard CT guided biopsy of the pleura
half had a PET-CT scan followed by the standard CT guided biopsy a few days later

The aim of this trial was to find out whether a PET-CT scan, followed by a CT guided biopsy is better at diagnosing cancer of the pleura. This is compared to having only the CT guided biopsy.

Summary of results

The team didn’t recruit as many people as they had hoped. 59 people took part:

29 had a CT guided biopsy
30 had a PET-CT scan followed by a CT guided biopsy

The team compared the 2 scans and the biopsy results. They looked at the number of people who were confirmed as:

having cancer of the pleura
not having cancer of the pleura

The team found that the number of people correctly identified as having cancer was similar between the 2 groups.

When researchers look at how reliable a test is they look at sensitivity. This means that if the person has the condition they are looking for, the test will be positive.

The results showed that the sensitivity of the biopsy to identify cancer of the pleura correctly was about the same for both groups.

The team also looked at the time it took to get the scan done and to get a confirmed diagnosis of cancer. This was about:

92 days in the group who had the PET-CT scan followed by CT guided biopsy
35 days in the group who had only the CT guided biopsy

Side effects
The team looked at the side effects of the scans. There were no unexpected side effects of having the scans.

Conclusion
This was a small trial. The team say these results show that adding a PET-CT to guide the biopsy wasn’t useful. It wasn’t better than having only the CT guided biopsy. It also took longer to get a PET-CT scan done.

The results also show that repeating a CT guided biopsy was reliable if the previous results weren’t clear.

Sometimes trials show that extra scans to diagnose cancer aren’t useful. But these trials still add to our knowledge and understanding of how best to diagnose cancer.

More detailed information
There is more information about this research in the reference below.

Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.

PET-CT-guided versus CT-guided biopsy in suspected malignant pleural thickening: a randomised trial
D de Foneska and others
European Respiratory Journal, 2024. Volume 63, issue 2, 2301295.

Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.