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

The purpose of this study was to investigate the utility of 18fluorodeoxyglucose (FDG) coincidence detection position emission tomography (CDET) in the evaluation of metastatic mediastinal lymph nodes in patients with potentially operable non-small-cell lung cancer (NSCLC). A prospective study was performed in thirty patients with newly suspected NSCLC. Thoracic computed tomography (CT), FDG CDET, and invasive surgical staging were performed in patients. Blinded prospective interpretation was performed for each test and compared to pathological staging obtained by mediastinoscopy and/or by thoracotomy. Patients were followed for six months to detect occult metastases. The sensitivity and specificity of CDET for the detection of mediaStinal lymph nodes were 75% and 94.4% respectively. The corresponding value for CT were 50% and 80.9%. Three patients with N1 disease were classified as N0 by CDET. With regard to definitive surgical node staging, CDET could identify nodal disease in 26 patients and CT only in 18 patients (n = 30). FDG full-ring positron emission tomography (PET) is the most accurate non-invasive method for the detection and staging of lung cancer. In addition, FDG CDET shows high accuracy for the detectability of pulmonary lesions with a diameter at least 2 cm and the evaluation of lymph node in NSCLC.
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PMID:[Value of 18FDG-CDET in the evaluation of operable bronchial cancer]. 1192 80

The first study evaluating directly by the referring physician the clinical impact of [18F]-FDG-PET on modification of patient's management was performed only recently in California by means of a questionnaire. We have used the same methodology to evaluate this clinical impact during the opening year of our PET centre in France. A questionnaire was sent to the referring physician of each of the 476 patients who had at least one routine FDG-PET examination during the year 2000. Of 348 responses (response rate = 73%), the disease was upstaged in 26% of the cases and down-staged in 9%. Intermodality management changes (change from a scheduled therapeutic modality for a different one) were reported in 37% of the cases and intramodality changes in 9%. Those modification rates were respectively 38% and 7% in recurrence of colorectal cancer (153 patients), 47% and 7% in lung cancer (118 patients), 16% and 23% in lymphoma (43 patients), 25% and 6% in the staging of head and neck cancers (32 patients). When comparing with the corresponding studies performed in California, there were no significant differences between the rates of intermodality management changes. In contrast, intramodality management changes were less frequent in our survey, except for lymphoma. Globally, the clinical impact of FDG PET was similar with a higher response rate in our study (73% versus 35%); it was above the mean rate derived from a recent meta-analysis in more than 5,000 patients.
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PMID:[Impact of [18F]-FDG-PET on medical decision making in oncology: evaluation by the referring physicians during the opening year]. 1194 Apr 70

Several tumors overexpress somatostatin receptors (SSTR) and can thus be imaged with radiolabeled analogues of somatostatin. Tc-99m depreotide is a new radiolabeled somatostatin analogue that shows high affinity for SSTR2, SSTR3, and SSTR5 subtypes. It has been recently FDA-approved for use in the evaluation of indeterminate solitary pulmonary nodules. SPECT with Tc-99m depreotide is highly accurate in this clinical setting and may be preferable to FDG-PET because of its lower cost and wider availability. Large studies are also underway to evaluate the accuracy of Tc-99m depreotide in staging of lung cancer.
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PMID:Somatostatin receptor imaging of non-small cell lung cancer with 99mTc depreotide. 1196 4

Lung cancer is currently the leading cause of cancer-related death in both men and women in most Western countries. Tumour stage is the strongest prognostic factor and the most important parameter guiding treatment decision making. Metabolic positron emission tomography imaging with fluorodeoxyglucose (FDG-PET) has consistently proved superior to conventional imaging for staging of non-small-cell lung cancer and provides information of greater prognostic significance than can be obtained using conventional approaches. FDG-PET has been approved in the USA, Germany and the UK as a basic and invaluable tool in the management of lung cancer.
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PMID:FDG-PET imaging in the management of non-small-cell lung cancer. 1199 64

[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.
Lung Cancer 2002 Jul
PMID:Whole body FDG-PET for the evaluation and staging of small cell lung cancer: a preliminary study. 1205 60

Recent advances in small cyclotrons, PET scanners, and image-processing software have made it possible to apply FDG-PET for clinical use, especially for tumor imaging. Although the efficacy of FDG-PET for several tumors remains a problem under discussion, the efficacy of PET for lung cancer has been studied in great detail and has already been established. The roles of FDG-PET for lung cancer management are, roughly speaking, 1) characterization of pulmonary nodules, 2) staging of lung cancer, 3) monitoring therapeutic effect, and 4) early diagnosis of tumor recurrence. We examined the usefulness of FDG-PET for lung cancer by analyzing our own data and reviewing recent reports. Two image-processing techniques, the image fusion technique and the respiratory-gated data-acquisition method, are also introduced in this article. FDG-PET is a promising method of anatomical imaging that is complementary to such techniques as CT and MRI. It may obtain a more important position among imaging modalities in the future.
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PMID:[Current status of nuclear medicine clinical application of FDG-PET for cancer diagnosis. Lung cancer]. 1207 30

While characterization of lung lesions and staging of lung cancer with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is an established clinical procedure, a lower diagnostic accuracy of FDG-PET for diagnosis and staging of so-called bronchioloalveolar carcinoma (BAC) has been reported. Therefore, the accuracy of PET for diagnosing and staging of BAC was investigated. We studied 41 patients eventually found to have adenocarcinoma with a bronchioloalveolar growth pattern who were referred for characterization or staging of lung lesions with whole-body FDG-PET between January 1998 and March 2001: there were 11 males (27%) and 30 females (73%), with a mean age of 66.0+/-10.9 (range =44-84 years). Patients were imaged using ECAT EXACT or HR+ systems. All patients had non-attenuation-corrected scans, while transmission data for attenuation correction were also available for 12 patients (29%). PET correctly identified BAC in 41 of the 46 (89%) lesions and 39 of the 41 patients (95%). By pathology, 25 patients (61%) were found to have unifocal or nodular lesions; this pattern was correctly identified by PET in 20 patients (80%) and by CT in 18 (72%). PET correctly identified 7 (44%) of 16 patients (39%) who had multicentric or diffuse BAC, and CT identified 11 (69%). Of the 35 patients whose lymph node status was verified pathologically, PET was correct in 27 (77%) and CT in 24 (69%). PET missed 67% of the rare tumors that had a pure BAC pattern with no invasive component. It is concluded that the diagnostic performance of whole-body FDG-PET is similar in most patients with lesions with a BAC pattern and in other non-small cell lung cancer types. PET is less accurate in patients with rare BAC tumors that have no invasive component.
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PMID:FDG-PET imaging in lung cancer: how sensitive is it for bronchioloalveolar carcinoma? 1219 61

The finding of a solitary pulmonary nodule on a chest radiograph is a common problem in pulmonary medicine and is seen in about 1 in 500 chest radiographs. Of the benign lesions, 80% are infectious granulomas, 10% are hamartomas, and the remaining 10% are caused by a variety of rarer disorders including noninfectious granulomas and other benign tumors. The prevalence of malignancy ranges from 10% to 68% in the literature. Because of the high prevalence of malignancy and the poor survival for lung cancer, early detection, characterization, and directed treatment are important. Positron emission tomography with 18-Fluorodeoxyglucose (FDG-PET) can play an important role in the evaluation and management of solitary pulmonary nodules. This includes improved characterization of solitary pulmonary nodules with very high negative predictive value and improved staging information when performed in association with CT, especially for nodal staging and identification of unsuspected stage IV disease. PET also provides additional information for management of solitary pulmonary nodules by estimating the probability of malignancy.
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PMID:PET scanning and the solitary pulmonary nodule. 1223 68

The aim of this study was to evaluate [18F]fluorodeoxyglucose ( F-FDG) imaging of recurrent or inoperable lung cancer using a hybrid positron emission tomography (PET) device of the third generation. Examinations were compared with the results of conventional staging. Thirty-six patients suffering from recurrent or primarily inoperable lung cancer (29 men, seven women; age 64.8+/-12.0 years) were examined using hybrid PET (Marconi Axis gamma-PET ) 60 min after injection of 370 MBq F-FDG. The data obtained were reconstructed iteratively. All patients received a computed tomography (CT) scan using either the spiral or multislice technique. All lesions suspicious for primary or recurrent tumour were verified by biopsy; mediastinal lymph nodes were considered as malignant, when positive histology or a small axis diameter of greater than 1 cm measured with CT in addition to progression of clinical course was found. Distant metastases were diagnosed by CT and bone scintigraphy. Using hybrid PET all lesions showed a focally elevated glucose metabolism. Lymph node involvement of the ipsilateral peribronchial and hilar station (N1) was identified in 24/26 cases (92%), in 26/29 cases (90%) of ipsilateral central manifestation (N2) and in 11/13 (85%) cases of central contralateral or supraclavicular lymphatic infestation (N3). Pulmonary spread in hybrid PET was found in 4/8 cases (50%), whereas mainly lung metastases with a diameter of 1.5 cm and smaller were missed. Pleural involvement diagnosed by CT was verified in 4/5 patients. All four patients with bony metastases in conventional staging also presented with positive findings in hybrid PET (8/9 lesions). Concordance with conventional staging was found in 28/36 of patients (78%). In 4/36 patients (11%) unknown sites of tumour were detected leading to therapeutic consequences in three patients after radiological confirmation. Hybrid PET would have led to an understaging in four cases (11%), resulting theoretically in inefficient treatment in two patients. Hybrid PET for F-FDG imaging in the staging of recurrent or primarily inoperable lung cancer supplied equal (78%) or more information (11%) compared to conventional staging procedures. Using the information of hybrid PET alone, 11% of the patients would have been understaged. We conclude that hybrid PET has the potential for use as an additional staging tool in this subgroup of patients, providing supplementary information compared to conventional staging modalities.
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PMID:Staging of recurrent and advanced lung cancer with 18F-FDG PET in a coincidence technique (hybrid PET). 1250 Oct 18

Combined modality treatment (CMT) for patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) is at present studied extensively. To select patients with truly stage IIIA-N2 disease, however, proves to be difficult with current diagnostic tests. Distant metastases may become clinically overt during induction chemotherapy (IC) or shortly after, revealing the inaccuracies of current staging algorithms. A prospective study with [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in IIIA-N2 NSCLC patients was performed to assess its value in the selection of this patient group. Fifty-seven patients received a whole body FDG PET scan as part of an ongoing response monitoring trial. Results were compared with conventional staging. In 32/57 (56%) PET suggested upstaging, which was confirmed in 17/57 (30%) with a median follow-up of 16 (range 2-49) months. These results show that using the conventional staging algorithm a substantial group of patients was understaged. FDG PET improves the selection of patients suitable for CMT.
Lung Cancer 2003 Feb
PMID:The value of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in the selection of patients with stage IIIA-N2 non-small cell lung cancer for combined modality treatment. 1258 67


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