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

18 FDG- PET is an imagining technique based on metabolic criteria rather than morphological criteria. (18) FDG- PET can demonstrate accelerated glycosis in cancer tissue related to increased transporter and glycolytic enzyme activity. Whole body PET is currently under validation in a growing number of indications during diagnostic and therapeutic assessment phases of cancer treatment. In the field of pulmonary oncology, (18) FDG- PET has already demonstrated its performance capacity to: 1) discriminate the malignant nature of a solitary pulmonary nodule, 2) improve sensitivity over CT for mediastinal assessment in small-cell lung cancer, 3) acquire whole body imaging to search for distant metastasis in patients with small-cell lung cancer; PET is particularly useful for evaluation of an adrenal mass, 4) complement CT imaging to better dissociate tumor residue or recurrence from post-therapeutic sequelae in small-cell lung cancer. Information provided by (18) FDG- PET is thus clinically relevant as it allows better dissociation of a benign process from a malignant process and better precision of small-cell lung cancer extension without necessitating systematic invasive exploration.
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PMID:[Contribution of positron emission tomography for the management of lung cancer]. 1081 Jan 98

One of the most important recent advances in imaging technology for the diagnosis of lung cancer is CT consisting of high-resolution and helical volumetric techniques. CT has made a detailed morphological analysis correlated with histopathology as well as the detection of small peripheral lung cancers possible. MRI still remains as a complementary role to CT, but MR angiography using fast gradient-echo technique has achieved a great progress. FDG-PET is the most encouraging development in nuclear medicine and is vigorously evaluated for its cost-effective clinical value in differentiating benign and malignant nodules as well as in staging of lung cancer. In chest radiography, the development of computer-aided diagnosis is underway and seems promising.
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PMID:[Diagnosis--radiologic imaging]. 1082 48

Although nuclear medicine imaging is still widely under-appreciated and underused by the medical and radiologic communities, FDG PET imaging and Tc 99m depreotide SPECT imaging are safe, cost-effective methods with advantages over CT and other imaging methods in the diagnosis and management of patients suspected or known to have lung cancer. Physicians involved in the care of these patients should familiarize themselves with both of these relatively new nuclear medicine imaging procedures. Both F-18 FDG PET imaging and Tc 99m depreotide SPECT imaging have a high degree of sensitivity, specificity, overall accuracy, and both PPV and NPV in the management of patients with a solitary pulmonary nodule. Nuclear imaging with either of these agents provides a noninvasive, cost-effective method to select patients for aggressive intervention without contributing to increased morbidity. There has not been a direct comparison of these two techniques in terms of their relative role and cost-effectiveness in the management of patients with a solitary pulmonary nodule. Both methods have incremental value over CT imaging in selecting patients with solitary pulmonary nodules either for invasive biopsy or for thoracotomy. To date, only FDG PET has been proved to have additional application in: 1. Improving the staging of patients by identifying or excluding mediastinal disease. Some authors are reluctant at the present time to deny patients an opportunity for curative resection based on the finding of foci of increased metabolism in the mediastinum (characterized by increased FDG activity) because there are occasional false-positive studies. They propose, however, that a negative study justifies a surgical approach (and an opportunity for cure) regardless of the findings on CT. 2. Evaluation of therapy and early detection of recurrence by using FDG PET imaging as a monitoring procedure. Tc 99m depreotide may have a role also in these other clinical indications for imaging in patients with lung carcinoma. It is too soon, however, to know if Tc 99m depreotide SPECT imaging, properly performed, can mimic the success of FDG PET in the detection or exclusion of mediastinal metastases, evaluating the response to therapy, and the early detection of recurrent disease during post-therapeutic monitoring.
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PMID:Nuclear medicine imaging of lung cancer. 1085 58

Positron emission tomography (PET) is a new diagnostic technique. It is used to differentiate benign from malignant pulmonary nodules and to detect metastasis and lymph node involvement in primary lung cancer, but little has been published about its possible interest for detection of unknown primary tumors. We report the case of a man who underwent resection of a cerebral tumor. A histological diagnosis of cerebral metastasis from adenocarcinoma with a probable pulmonary origin was made. Preoperative staging (including thoracoabdominal CT-scan and bone scan) did not show any pathologic image, particularly in the thorax. A whole body FDG-PET-scan was then performed. An isolated (1.5 cm of diameter) hypermetabolic focus was discovered in the left upper lobe. Bronchoscopy was normal An upper left lobectomy confirmed the presence of the primary lung adenocarcinoma. In this particular case, FDG-PET proved to be a very useful diagnostic method. New indications are being developed for it.
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PMID:FDG-PET detection of primary lung cancer in a patient with an isolated cerebral metastasis. 1095 51

Approximately 170,000 people are diagnosed with lung cancer in the United States each year. Many of these patients receive external beam radiation for treatment. Fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) is increasingly being used in evaluating non-small cell lung cancer and may be of clinical utility in assessing response to treatment. In this report, we present FDG PET images and data from two patients who were followed with a total of eight and seven serial FDG PET scans, respectively, through the entire course of their radiation therapy. Changes in several potential response parameters are shown versus time, including lesion volume (V(FDG)) by PET, SUVav, SUVmax, and total lesion glycolysis (TLG) during the course of radiotherapy. The response parameters for patient 1 demonstrated a progressive decrease; however, the response parameters for patient 2 showed an initial decrease followed by an increase. The data presented here may suggest that the outcome of radiation therapy can be predicted by PET imaging, but this observation requires a study of additional patients.
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PMID:Use of PET to monitor the response of lung cancer to radiation treatment. 1095 99

F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging is being increasingly utilized in the detection of malignancy and in following the effects of therapy. FDG-PET imaging has been demonstrated to be accurate in the diagnosis of several malignancies including lung cancer, lymphoma, recurrent colorectal cancer, and recurrent melanoma. The initial studies evaluating FDG-PET in determining the effect of therapy reveal promising results. The clinical images are interpreted subjectively like other clinical nuclear medicine imaging studies. Semiquantitative indices such as the standardized uptake value may be used for research purposes to provide a quantitative parameter from the study.
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PMID:FDG imaging. 1109 Nov 13

In summary, noninvasive clinical staging techniques aid in stratifying patients into similar prognostic and therapeutic categories. Every patient with presumed non-small cell lung cancer should undergo a thorough history and physical examination, basic routine laboratory testing, PA and lateral chest radiographs, and chest CT scan with upper abdominal cuts to allow evaluation of the liver and adrenals. Recently, FDG-PET scanning has shown tremendous promise in the noninvasive evaluation of the primary tumor, nodal involvement, and metastatic [table: see text] disease. Although valuable, clinical staging has limitations, and when pathologic confirmation of lung cancer is required, minimally invasive techniques, such as bronchoscopy, TTNA, thoracoscopy, anterior mediastinotomy, and cervical and extended mediastinoscopy, may be valuable and simple ways of obtaining tissue.
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PMID:Staging techniques for lung cancer. 1109 26

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

Purpose: The frequency of adrenal metastases from non-small cell lung cancer (NSCLC) varies between 4 to 25%. Adrenal metastases are frequently missed (78%) by Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). The purpose of this study was to characterize the patterns of adrenal gland involvement from lung cancer by 18-F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET).Methods: Retrospective review of patients evaluated for known or suspected lung carcinoma. Results of 18FDG-PET, CT, MRI, and scans were compared.Results: From February 1996 to May 2000, 91 patients with known (85 patients) or suspected (6 patients) lung cancer were evaluated with 18FDG-PET scan. Twenty-two patients (mean age 63, range 38-88 years) had abnormal adrenal glands by either 18FDG-PET (16 patients), CT (12 patients) or MRI (1 patient). In 13 cases 18FDG-PET scan was ordered to clarify CT or MRI findings. Only 7 patients showed adrenal gland involvement: 5 patients (5.5%) with unilateral disease and 2 patients (2.2%) with bilateral disease. PET depicted unsuspected findings in 9 patients: 8 patients (8.8%) with unilateral disease and 1 patient (1.1%) with bilateral disease.(18)FDG-PET upstaged 9 patients from limited (N1M0) to widespread disease (M1), thus obviating surgical intervention.Conclusion: This study demonstrates the potential of 18FDG-PET scanning in revealing unsuspected adrenal metastases in patients with early stages of NSCLC as well as characterizing CT or MRI equivocal adrenal masses.
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PMID:12. Patterns of Adrenal Gland Involvement from Lung Cancer Shown by 18F-Fluorodeoxyglucose Positron Emission Tomography Compared to Computed Tomography and Magnetic Resonance Imaging. 1115 Jul 69

Background: In cost-effective analysis regarding to utilization of FDG-PET on lung nodules, most studies focused on lung lesions themselves (benign vs. malignant) and possible metastases if primary lesion is malignant. However, in a patient with pulmonary nodules, abnormal sites of increased FDG uptake on a whole-body PET scan may either the primary tumor or lesions unrelated to lung malignancy. The incidence of detection of the unsuspected lesions, which often changes the management of these patients, should also be included in the cost-effective analysis.Methods: We retrospectively analyzed 213 cases referred for evaluation of pulmonary nodules. 89 of them proved to have lung malignancy and were excluded in our study. None of the remaining 124 patients had prior clinical or radiographic evidence of other abnormalities before undergoing FDG-PET. All unsuspected lesions were verified either histologically or by the clinical course of the disease.Results: Among the 124 patients without lung cancer, FDG-PET revealed unsuspected abnormality in eight patients. These include other malignancy (colon cancer x 3, lymphoma x 1) and benign lesions (sarcoidosis x 3, cystic kidney x 1). None of the 124 patients studied had additional pathology found during follow-up.Conclusion: The routine uses of FDG-PET for characterizing the lung lesions significantly increases the chances detecting unexpected other pathology. The incidental FDG-PET findings of unsuspected lesions, especially those unrelated to lung cancers, no doubt have a major impact on the management of these patients and may prove to be cost-effective.
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PMID:26. Incidental findings should be included in the analysis of cost-effectiveness for evaluation of pulmonary nodules by FDG-PET. 1115 Jul 83


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