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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Memory loss can be a symptom of paraneoplastic limbic encephalitis (PLE) a neuropsychiatric disorder associated mostly with small-cell lung cancer and anti-Hu antibodies or with testicular tumors and anti-Ma2 antibodies. We present the case of a patient with temporal coincidence of beginning cognitive decline and diagnosis of a carcinoma of the prostate in whom we diagnosed anti-Ma1/Ma2-positive PLE. The tumor had been completely resected but memory impairment further deteriorated. As the effective treatment of the cancer is considered as the most efficient treatment of a paraneoplastic neurological syndrome (PNS) a second neoplasia was suspected in the patient. By the aid of whole body positron emission tomography with 18-fluorine fluoro-2-deoxy-glucose (FDG-PET) an adenocarcinoma of the cecum could be detected. Two months after surgery anti-Ma antibodies were negative. We conclude that a second neoplasia should be considered, if effective cancer treatment does not lead to improvement or stabilisation of a PNS. Tumor search should be exhaustive and include PET when conventional imaging fails to show a malignancy.
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PMID:Second primary tumor in anti-Ma1/2-positive paraneoplastic limbic encephalitis. 1631 42

Fluoro-deoxyglucose positron emission tomography (PET) imaging has a diagnostic and prognostic value in the initial staging, restaging, and surveillance of non-small-cell lung cancer (NSCLC). When used in conjunction with conventional radiologic imaging, PET imaging has been shown to result in significant changes in clinical management of NSCLC. Specifically, baseline PET imaging can improve initial staging and guide surgical and radiotherapy planning, whereas repeat PET imaging after the initiation of chemoradiotherapy can predict tumor response and help tailor therapy. After the end of definitive treatment, PET has greater diagnostic accuracy than other imaging modalities for the detection of tumor recurrence. The recent development of fused PET/CT imaging has improved the radiologic evaluation of NSCLC patients by combining metabolic and anatomic imaging; however, this has resulted in more complexity in the image interpretation. It is important for the interpreting physician to understand the role PET/CT plays in the staging, assessment of treatment, and follow-up after therapy in the multidisciplinary management of patients with NSCLC.
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PMID:PET/CT imaging of lung cancer. 1677 Feb 29

The aim of this study was to demonstrate the possibilities, advantages and limitations of virtual bronchoscopy using data sets from positron emission tomography (PET) and computed tomography (CT). Twelve consecutive patients with lung cancer underwent PET/CT. PET was performed with F-18-labelled 2-[fluorine-18]-fluoro-2-deoxy-D: -glucose ((18)F-FDG). The tracheobronchial system was segmented with a volume-growing algorithm, using the CT data sets, and visualized with a shaded-surface rendering method. The primary tumours and the lymph node metastases were segmented for virtual CT-bronchoscopy using the CT data set and for virtual PET/CT-bronchoscopy using the PET/CT data set. Virtual CT-bronchoscopy using the low-dose or diagnostic CT facilitates the detection of anatomical/morphological structure changes of the tracheobronchial system. Virtual PET/CT-bronchoscopy was superior to virtual CT-bronchoscopy in the detection of lymph node metastases (P=0.001), because it uses the CT information and the molecular/metabolic information from PET. Virtual PET/CT-bronchoscopy with a transparent colour-coded shaded-surface rendering model is expected to improve the diagnostic accuracy of identification and characterization of malignancies, assessment of tumour staging, differentiation of viable tumour tissue from atelectases and scars, verification of infections, evaluation of therapeutic response and detection of an early stage of recurrence that is not detectable or is misjudged in comparison with virtual CT-bronchoscopy.
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PMID:Virtual positron emission tomography/computed tomography-bronchoscopy: possibilities, advantages and limitations of clinical application. 1690 19

The available tools for diagnosing and staging lung cancer patients can be broadly categorized into non-invasive, minimally invasive and invasive (surgical) modalities. Non-invasive modalities include CT and PET. Minimally invasive modalities are endoscopic approaches, including endoscopic ultrasound, endobronchial ultrasound and transbronchial fine needle aspiration without ultrasound guidance. This review focuses on the non-invasive and minimally invasive techniques involving imaging. Application of Bayesian principles indicates that tests with a high sensitivity and specificity for detection of both systemic metastases and mediastinal nodal involvement are required for treatment selection and planning in patients with non-small cell lung cancer who would be considered for treatment with curative intent. Combined PET/CT using the glucose analogue fluorine-18 fluorodeoxyglucose currently provides the best diagnostic performance for this purpose and should now be considered the standard of care for staging non-small cell lung cancer. Endoscopic ultrasound and endobronchial ultrasound have important complementary roles to allow further evaluation of equivocal nodal abnormalities on PET or CT and to allow pathological samples to be obtained. Diagnostic CT has an important role in defining tumour relations for patients deemed suitable for surgical resection and as the initial investigation for patients with potential symptoms of lung cancer or proven lung cancer that would not be considered for curative treatment on medical grounds.
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PMID:Imaging in the diagnosis and treatment of non-small cell lung cancer. 1729 47

The aim of our study was to analyze how many oncology patients might benefit from a) integrated positron emission tomography - multidetector computed tomography (PET/MDCT) and additionally b) clinically relevant information provided by either the CT scan or PET scan. A total of 285 consecutive patients 164 male and 121 female, age range 17-84 years, 153 lung cancer, 112 lymphoma, 20 miscellaneous, referred for PET and separate CT scan, were included. The CT scan was performed after the intravenous injection of a soluble contrast media. Patients were retrospectively classified into six Groups: Group I: No pathological uptake on the PET scan, Group II: Suspected lesions were correctly identified by the PET scan alone, Group III: Side-by-side evaluation of PET and CT appeared sufficient to assess the localization of lesions, Group IV: Side-by-side reading was not sufficient and integrated PET/CT was considered beneficial. Additionally all patients with a CT scan with additional clinical relevant information (not visualized by the PET scan) were classified in Group V. Group VI was set for lesions detected by PET alone (not visualized by the CT scan). The CT scan was used as the gold standard to confirm or disprove PET lesion localization. Our results showed: A number of 77 patients, (Group I: 77/285, 27%) had no pathologic fluorine-18-fluorodeoxyglucose (18F-FDG)-uptake. Lesions were correctly localized by either conventional PET alone (Group II: 76/285, 27%) or side-by-side evaluation of PET and CT scans (Group III: 44/285, 15%). Integrated PET/CT or software fusion, was considered beneficial in 31% (88/285) of the patients with pathological 18F-FDG-uptake (Group IV). Additionally to the above, in 15% of all patients clinically relevant information, referring to disseminated small pulmonary lesions, abdominal aortic aneurysms >5 cm, thrombi or pulmonary emboli, was also provided by the CT scan (Group V). Also, in 7% of all patients, unsuspected pathological lesions, mainly bone metastases, were correctly detected by PET alone (Group VI). In conclusion, in 54% of all oncologic patients, PET alone was diagnostic. In 46% of all patients side-by-side reading (15%) or integrated PET/CT images (31%) were considered beneficial for more accurate anatomical localization of the lesions. Additionally, the CT scan added clinically relevant information in 15% of all patients and the PET scan showed unsuspected metastases in 7% of all studied patients. Therefore, integrated reading of PET and MDCT images by nuclear physicians and radiologists may gain quality in the staging of oncology patients.
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PMID:Diagnostic evaluation of separately acquired PET and CT images by nuclear medicine physicians and radiologists in cancer patients. 1768 86

Positron emission tomography (PET) using 18F-2-deoxy-D-glucose, a D-glucose analog labeled with fluorine-18, complements conventional radiologic assessment in the evaluation of patients with nonsmall-cell lung cancer (NSCLC). PET is being routinely used to improve the detection of nodal and extrathoracic metastases. PET is also currently being evaluated in the assessment of prognosis and therapeutic response and by potentially allowing an earlier assessment of response may prove invaluable in the oncologic management of patients. The article discusses the diagnosis, staging, and assessment of treatment response and prognosis with an emphasis on the appropriate clinical use of PET in management.
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PMID:Positron emission tomography imaging in nonsmall-cell lung cancer. 1789 84

Many asbestos-like mineral fibers have been detected in the air of mountainous and volcanic areas of Italy and other parts of the world. These fibers have been suspected to be the cause of increased incidences of lung cancer and other lung diseases in these areas. However, the mechanisms of the cellular response and defense following exposure to these microscopic fibers have not been characterized. We continue to study these mechanisms to be able to propose preventive strategies in large populations. The objective of the present study was to determine comparatively biological responses of mesothelial Met-5A and monocyte-macrophage J774 cells following exposure to two types of fluoro-edenite fibers having low and high iron content (labeled 19 and 27, respectively) obtained from Biancavilla (Sicily, Italy). The reference fiber was a non-iron fibrous tremolite from Val di Susa (Piemonte, Italy). The cells were treated with 5, 50, and 100 mug of fibrous matter per 1 ml for 72 hr. We identified several key mechanisms by which cells responded and counteracted the injury induced by these fibers. The fibers caused induction of the heat shock protein 70 (Hsp70), stimulated formation of reactive oxygen species (detected by using DCFH-DA as a fluorescent probe) and NO* (measured as nitrite). Exposure of cells to the fibers induced lactate dehydrogenase activity and decreased viability. The fluoro-endenite type 27 was the most potent fiber tested, which indicated that iron and possibly manganese contribute significantly to this fiber toxicity. The J774 cells were more sensitive to fluoro-edenite than Met-5A cells suggesting that the primary site of the fiber-induced inflammatory response could be the macrophage rather than the pulmonary epithelium. Fluoro-edenite produces more biological alterations with respect to non-iron tremolite. Hsp70 and free radicals could be important factors in the context of mineral fiber-induced acute lung injury leading possibly to mutagenic effects. We anticipate that pharmacological blockade of the fiber-dependent cellular responses could in long term offer preventive approach to combat lung diseases induced by these fibers.
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PMID:Fluoro-edenite fibers induce expression of Hsp70 and inflammatory response. 1791 57

Molecular imaging of the body involves new techniques to image cellular biochemical processes, which results in studies with high sensitivity, specificity, and signal-to-background. The most prevalently used molecular imaging technique in body imaging is currently fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET). FDG PET has become the method of choice for the staging and restaging of many of the most common cancers, including lymphoma, lung cancer, breast cancer, and colorectal cancer. FDG PET has also become extremely valuable in monitoring the response to therapeutic drugs in many cancers. New PET agents, such as fluorothymidine and acetate, have also shown promise in the evaluation of response to therapy and in the staging of prostate cancer. Magnetic resonance (MR) spectroscopy has shown promise in the evaluation of prostate cancer. Breast cancer evaluation benefits from advances in spectroscopic imaging and contrast-enhanced kinetic evaluation of vascular permeability, which is altered in neoplastic processes because of release of angiogenic factors. Superparamagnetic iron oxide (SPIO) particles represent the first of an expanding line of MR contrast agents that target specific cellular processes. SPIO particles have also been used in the evaluation of the cirrhotic liver and at MR lymphangiography.
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PMID:Molecular imaging techniques in body imaging. 1794 Feb 97

We aimed to evaluate the efficacy of (18)fluorine fluorodeoxyglucose ((18)F FDG) PET/CT for the characterization of solitary pulmonary nodules (SPNs) compared with the use of PET alone or CT alone. Our institutional review board approved this retrospective study with a waiver of informed consent. We selected 100 patients (M:F=56:44, mean age; 58 years) with a pathologically proven solid or partly solid SPN. Three chest radiologists assessed the nodule characteristics independently and retrospectively. Diagnostic efficacies were compared for three different approaches: consideration of CT findings only, PET findings only, and both PET and CT findings. The McNemar test, kappa statistics, and receiver operating characteristics (ROC) curve analysis were performed. Sixty patients had benign and 40 had malignant nodules. Overall sensitivity values for malignant SPNs for CT, PET and PET/CT were 82%, 88%, and 88%, respectively, whereas the specificity values were 66%, 71%, and 77%, respectively. PET/CT was significantly better in terms of specificity than the use of PET alone or CT alone (P<.05). The areas under curve (Az) values for the ROC analyses of PET/CT and PET alone, respectively, were larger than that of CT alone (P<.05). Interobserver agreement was moderate (kappa=0.46-0.56) for CT, good to excellent (kappa=0.78-0.90) for PET, and good for PET/CT (kappa=0.64-0.78). For the characterization of SPNs, integrated PET/CT provides significantly better specificity than CT alone or PET alone and both integrated PET/CT and PET alone allow more confidence than CT alone.
Lung Cancer 2008 Aug
PMID:Efficacy of PET/CT in the characterization of solid or partly solid solitary pulmonary nodules. 1828 Jun 13

Dry pleural dissemination in non-small cell lung cancer, defined as solid pleural metastasis of lung cancer without pleural effusion, is a condition occurring in T4 lung cancer. Positron emission tomography (PET) has been reported to be useful for the diagnosis and staging of lung cancer. It has been reported that positive findings on PET scans of indeterminate pleural abnormalities at computed tomography (CT) are sensitive to malignancy. We encountered two cases of dry small pleural dissemination of adenocarcinoma of the lung preoperatively detected by PET/CT. A 75-year-old man and a 66-year-old man underwent CT scan, which demonstrated solitary tumor in the lung, an enlarged mediastinal lymph node, and a small pleural nodule less than 10 mm in size, all of which were positive findings on the fluorine 18 fluorodeoxyglucose (FDG) PET portion of an integrated PET/CT. Both patients underwent thoracoscopic biopsy of the dry pleural nodule revealing dissemination of adenocarcinoma of the lung (T4). Whereas histological thoracoscopic diagnosis remains mandatory before planning treatment, our cases may suggest that PET/CT will be useful as a screening modality for dry pleural dissemination of lung cancer.
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PMID:Dry small pleural dissemination of adenocarcinoma of the lung preoperatively detected by PET/CT: a report of two cases. 1832 64


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