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Query: UMLS:C0149925 (small cell lung cancer)
 6,491 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Purpose: To examine the value of PET in diagnosis and staging of suspected lung cancer.Methods: 20 (13 male; mean age: 56 yr., range: 22-83 yr.) patients with chest X-ray findings suspicious of malignancy were staged a) "clinically" (X-ray, history/physical examination, lung function), b) by chest CT of thorax/upper abdomen, and c) by whole-body PET (GE Advance, visual analysis). The CT and PET studies were performed within 2 weeks of admission and read blinded to all information except the chest X-ray report. The decision to refer to mediastinoscopy/thoracotomy was made by a tumor board using clinical information, CT and PET findings. In principle, suspected metastatic lesions were biopsied before surgery. The gold standard was histology from biopsy or thoracotomy, or resolution of the X-ray findings and symptoms.Results: One patient was excluded because of uncertain diagnosis. In 3 (15%) patients surgery was avoided mainly because of the PET findings. In one SCLC patient and one lymphoma patient, PET showed extensive disease, which changed the chemotherapy regime. Accuracy was 83% for clinical stage, 79% for CT and 77% for PET. Four (20%) false positive PET findings were caused by granuloma, pneumonia and BOOP. These nodules were only 1 to <3 cm, while malignant nodules were 2-8 cm. There were no false negative PET or CT studies.Conclusion: FDG-PET is valuable in patients suspected for pulmonary malignancy, since thoracotomy was avoided in 15% of patients and in 10% of patients more extensive disease was found which changed the chemotherapy regime.
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PMID:4. Preliminary Findings of a Prospective Study of FDG-PET in Patients with Possible Lung Cancer. 1115 Jul 61

Paraneoplastic syndromes may be the presenting clinical manifestation of small cell lung cancer. In some cases, however, confirming the diagnosis can be difficult because findings on conventional imaging studies can be subtle or nonspecific. This study examined the utility of fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) in identifying clinically suspected small cell lung cancer in patients with paraneoplastic syndromes. FDG-PET appears to be very useful in localizing suspected small cell lung cancer in patients presenting with paraneoplastic syndromes.
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PMID:FDG-PET imaging in patients with paraneoplastic syndromes and suspected small cell lung cancer. 1129 10

The staging procedures for small cell lung cancer do not differ appreciably from those for other forms of lung cancer. For practical purposes, the TNM stages are usually collapsed into a simple binary classification: limited disease and extensive disease. This study was performed to answer the question of whether fluorine-18 labelled 2-deoxy-2-D-glucose positron emission tomography (FDG-PET) imaging permits appropriate work-up (including both primary and follow-up staging) of patients presenting with small cell lung cancer, as compared with currently recommended staging procedures. Thirty-six FDG-PET examinations were performed in 30 patients with histologically proven small cell lung cancer. Twenty-four patients were examined for primary staging while four were imaged for therapy follow-up only. Two patients underwent both primary staging and up to four examinations for therapy follow-up. Static PET imaging was performed according to a standard protocol. Image reconstruction was based on an ordered subset expectation maximization algorithm including post-injection segmented attenuation correction. Results of FDG-PET were compared with those of the sum of other staging procedures. Identical results from FDG-PET and the sum of the other staging procedures were obtained in 23 of 36 examinations (6x limited disease, 12x extensive disease, 5x no evidence of disease). In contrast to the results of conventional staging, FDG-PET indicated extensive disease resulting in an up-staging in seven patients. In one patient in whom there was no evidence for tumour on conventional investigations following treatment, FDG-PET was suggestive of residual viability of the primary tumour. Furthermore, discordant results were observed in five patients with respect to lung, bone, liver and adrenal gland findings, although in these cases the results did not affect staging as limited or extensive disease. Moreover, FDG-PET appeared to be more sensitive for the detection of metastatic mediastinal and hilar lymph nodes and bone metastases. Finally, all findings considered suspicious for tumour involvement on the other staging procedures were also detected by FDG-PET. It is concluded that FDG-PET has potential for use as a simplified staging tool for small cell lung cancer.
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PMID:FDG-PET imaging for the staging and follow-up of small cell lung cancer. 1135 99

[F18]-2-deoxy-2fluoro-D-glucose positron emission tomography (FDG-PET) is increasingly used in the diagnosis and staging of lung cancer. Despite its positive performance characteristics in non-small cell lung cancer (NSCLC), the role of FDG-PET in the staging of small cell lung cancer (SCLC) remains to be determined. We designed a prospective study to address this question. Eighteen patients with SCLC were enrolled prospectively to undergo total body FDG-PET in addition to conventional staging procedures (chest computed tomography (CT), abdominal CT, cranial CT or magnetic resonance imaging (MRI), and bone scan/bone marrow biopsy). The agreement between FDG-PET and conventional staging modalities in identifying the presence or absence of metastatic disease was compared using the Veterans Administration (VA) cooperative staging system for staging. Overall staging by FDG-PET agreed with conventional staging exams in 15/18 (83%) patients (kappa=0.67), which included eight extensive and seven limited cases. FDG-PET showed more extensive disease in two of the three patients for which FDG-PET and conventional staging disagreed. These data suggest that total body FDG-PET may be useful in the staging, treatment planning, and prognostication of SCLC. Whether FDG-PET will replace other more established staging modalities remains to be determined by larger prospective randomized controlled studies.
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PMID:Whole body FDG-PET for the evaluation and staging of small cell lung cancer: a preliminary study. 1205 60

The purpose of this study was investigate the role of 18F-2deoxyglucose positron emission tomography (FDG-PET) in staging small cell lung cancer (SCLC), its efficacy for the discrimination of limited disease (LD) and extensive disease (ED) stages and its regional sensitivity for different metastatic locations. Twenty-five patients with histologically confirmed SCLC and 42 radiologically-staged tumor sites were retrospectively investigated. The LD sample included 10 patients while the ED included 15 patients. All of the 25 primary tumor sites (100%) were visualized and 41 out of 42 (97.6%) of the metastases could be identified, but FDG-PET was needed for anatomical localization. The efficacy of FDG-PET was studied in the staging of SCLC patients and compared with the initial staging of conventional modality findings. FDG-PET down-staged (from ED to LD) one case and up-staged (from LD to ED) one case of SCLC. In summary, all of the patients with ED were correctly staged by FDG-PET alone. We conclude that FDG-PET is a substantial tool in the staging work-up of SCLC if it is performed initially to allow fast identification of patients with extensive disease stages and thus saves additional radiological or invasive examinations. Our preliminary results support the usefulness of whole body FDG-PET for staging SCLC.
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PMID:Whole-body 18F-2-deoxyglucose positron emission tomography in primary staging small cell lung cancer. 1216 35

We encountered a very rare case of cT0N2M0 small cell lung cancer (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old man with a complaint of muscle weakness was admitted to our hospital. Although his chest radiograph on admission showed no abnormal findings, CT scanning detected a mediastinal lymphadenopathy. Also, 2-[18F]-2-fluorodeoxy-D-glucose position emission tomography (FDG-PET) revealed increased accumulation in the same portion in the mediastinum. A diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings (waning and waxing phenomenon in response to low-and high-frequency repetitive stimulation, respectively) in combination with the increased serum level of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody. Subsequent histopathological diagnosis by mediastinoscopic resection of a paraaortic lymph node was small cell carcinoma. No distant metastasis was detected by MRI of the brain, abdominal CT scan or an FDG-PET. Eight courses of chemotherapy (carboplatin + etoposide) with radiotherapy of the mediastinum (for a total dose of 45 Gy) was performed. A decreased serum level of P/Q-type anti-VGCC antibody titers followed by marked improvement of neurological dysfunction (muscle weakness, gait disturbance and scanning speech) and of an EMG finding (a loss of waning phenomenon) was observed. A close relationship between reduction of the antibody titers and improvement of neurological symptoms after the therapy was noticed. It was suggested that monitoring the level of a P/Q-type anti-VGCC antibody titer in the serum is important for evaluating the efficacy of chemotherapy for LEMS associated with SCLC.
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PMID:[A case of cT0N2M0 small cell lung cancer with Lambert-Eaton myasthenic syndrome]. 1550 Jan 50

In our hospital as in many others, primary lung cancer is the most frequent indication for FDG PET. Studies have assessed the clinical utility of this imaging modality in characterizing solitary pulmonary nodules or masses, initial staging, defining tumor volume in radiotherapy and searching for recurrence of or restaging non-small cell carcinoma; studies are currently underway to evaluate its use in early assessment of chemotherapy response. Small cell lung cancer has a high FDG uptake and PET/CT can be useful for rapid staging. False negative results may be due to pure bronchioloalveolar carcinomas and endocrine tumors. FDG-PET will certainly play a more important role in the diagnosis and follow-up of pleural cancers in the future. An unexpected positive FDG PET focus should be considered as a warning, but histological proof should precede any irrevocable decisions.
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PMID:[PET in primary pulmonary or pleural cancer]. 1696 35

We retrospectively investigated the clinical usefulness of fluorodeoxyglucose positron emission tomography (FDG-PET) for evaluation of patients with limited-disease small-cell lung cancer (LD-SCLC) diagnosed by conventional staging procedures. Sixty-three patients received whole body FDG-PET scans after routine initial staging procedures. The findings of FDG-PET scans suggesting extensive-stage disease were confirmed by other imaging tests or by the patient's clinical course. FDG-PET scan findings indicated distant metastases in 6 of 63 patients. Metastatic disease was confirmed in five of these six patients (8%, 95% confidence interval: 3-18%). FDG-PET scan also detected regional lymph node metastases even in nine patients (14%) in whom computed tomography images had been negative, including contralateral lymph node metastasis in three patients. FDG-PET scan detected additional lesions in patients diagnosed as having LD-SCLC by conventional staging procedures. The therapeutic strategies were changed in 8% of patients based on the results of FDG-PET. FDG-PET scan is recommended as an initial staging tool for patients with this disease.
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PMID:Detection of unsuspected distant metastases and/or regional nodes by FDG-PET [corrected] scan in apparent limited-disease small-cell lung cancer. 1753 38

The purpose of this study was to assess the feasibility of PET/CT in response evaluation of patients with small cell lung cancer (SCLC). Among the 25 patients with primary small cell lung cancer who had been treated from August 2004 through to May 2008, we compared the response evaluation between conventional CT and fluoro-2-deoxyglucose positron emission tomography (FDG-PET), [CMR (Complete Metabolic Response), PMR (Partial Metabolic Response), SMD (Stable Metabolic Disease), PMD (Progressive Metabolic Disease)] before and after the treatment. Response assessment was discordant in 2 out of 25 cases (8%) after the first cycle of chemotherapy and in 3 out of 19 cases (16%) after the fourth cycle of chemotherapy. Two discordant cases after the first cycle of chemotherapy were PR and SD respectively by CT but both were found to be PMD by PET. Two out of three discordant cases after the fourth cycle of chemotherapy were PR by CT but both found to be CMR by PET. These results suggest that FDG-PET is useful for response assessment of early diagnosis of recurrence and prognostic outlook in small cell lung cancer, however further cases need to be collected.
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PMID:[Efficacy of fluoro-2-deoxyglucose positron emission tomography imaging in response evaluation of patients with small cell lung cancer (pilot study)]. 2005 82

A 58-year-old man complaining of increasing weakness of muscular leg strength, diplopia and ptosis was admitted to our hospital. An electromyogram (EMG) showed typical waxing phenomenon in response to high-frequency repetitive stimulation. A diagnosis of Lambert-Eaton myasthenic syndrome (LEMS) was made from his symptoms and EMG results. A chest CT showed mediastinal lymph node swelling. No abnormal mass was seen in either lung field. His serum levels of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody, Pro-GRP, and NSE were high. FDG-PET showed accumulation of FDG to the mediastinal and left inguinal lymph nodes. The left inguinal lymphadenopathy was pathologically diagnosed as metastasis of small cell lung carcinoma. No tumor could be detected by bronchofiberscopy. No other distant metastasis was detected by brain MRI, abdominal CT, or FDG-PET. After 6 courses of chemotherapy for SCLC, a partial response and reduction of symptoms were obtained. For assessment of indistinguishable neuropathic symptoms, the possible diagnosis of paraneoplastic syndrome, such as LEMS, and the fact that early treatment for primary disease was effective, should be considered.
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PMID:[A case of small cell lung carcinoma without apparent primary lesion accompanying Lambert-Eaton myasthenic syndrome]. 2005 96


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