ABSTRACT
Background: PET/CT (Positron Emission Tomography/Computed Tomography) is widely used in nodal and metastatic staging of lung cancer patients. Aim: To analyze PET/CT detection of metastatic disease in patients with lung cancer. Material and Methods: We reviewed retrospectively F18Fluorodeoxyglucose PET/CT scans performed between December 2008 and December 2013. We selected 143 patients aged 30 to 92 years (63% males) with confirmed lung cancer referred for staging, with no previous treatment. We reviewed whole body PET/CT and brain magnetic resonance images. SUVmax (Standardized Uptake Value maximum) of primary pulmonary lesion, hilar/mediastinal nodes, and distant metastases were calculated. Results: Histological types encountered were adenocarcinoma in 55%, squamous-cell in 15%, small-cell in 8%, large-cell in 6% and adeno-squamous in 2%. In 22 cases (15%) histology was not available. Nodal involvement was observed in 60% of patients (44% hilar and 48% mediastinal). Skip metastases (mediastinal involvement without hilum involvement) were encountered in 17% of cases, and were significantly more common among high uptake lung tumors (p < 0.01). Best SUVmax cut-off for node involvement was 4.4 for hilum and 4.0 for mediastinum (sensibility: 86.4%, specificity: 99.8%). Sixty six patients (46.2%) showed distant metastases on PET/CT. The most common metastases were osseous in 22%, adrenal in 16%, hepatic in14%, pulmonary in 14% and cerebral in 12%. PET/CT detected a second unexpected synchronic cancer in eight patients (6%). Conclusions: PET/CT is accurate for nodal staging using an uptake index as SUVmax. Distant metastases are common, especially in bone, adrenal glands and liver.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , Health Planning Guidelines , Pregnancy Complications/ethnology , Pregnancy Outcome/ethnology , Weight Gain , Body Mass Index , Infant, Small for Gestational Age , Parity , Risk Factors , SmokingABSTRACT
Metabolic imaging studies are an integral part of oncology practice, particularly with 18 fuorodeoxyglucose PET scanning. Lung cancer is one of the primary indications of a PET/CT study. It is helpful in staging, evaluating treatment response and follow-up of these patients. The recent development of PET/CT, which incorporates a multislice CT scanner to the PET detector, improves results, combining metabolic information from the PET with anatomic data obtained with CT. It reduces false positive results from PET in cases of inflammatory disease such as pneumonia or Drug reactions, which are frequent in this group of patients. These conditions are easily recognized by CT. It also improves the detection of primary tumors, when they are adjacent to atelectasis or desmoplastic reactions. PET-CT studies are able to characterize the metabolism of mediastinal and hilar lymph nodes, thus obviating the need for further related imaging studies or invasive procedures. In the assessment of metastatic disease, it allows a whole body analysis in only one study, with high predictive value and optimal cost-benefit relation. The detection of a second primary tumor is not infrequent in these patients. PET-CT is useful in the evaluation of treatment response after chemotherapy, and for the long term follow-up.
Subject(s)
Humans , Lung Neoplasms , Lung Neoplasms , Positron-Emission Tomography/methods , Radiopharmaceuticals , Tomography, X-Ray ComputedABSTRACT
La técnica híbrida PET/CT ha sido utilizada en el estudio inicial y seguimiento de neoplasia malignas, con óptima relación costo/beneficio.El objetivo de este trabajo fue evaluar la aparición de neoplasias no sospechadas en pacientes que se realizaron un PET/CT de cuerpo entero en nuestro Servicio.Método: Se revisaron 354 PET/CT realizados entre enero de 2009 y enero de 2010, registrándose aquellos exámenes de cuerpo entero que detectaron una neoplasia no sospechada, que no tenía relación con la indicación del examen.Resultados: Se pesquisaron 11 neoplasias no sospechadas en 11 pacientes que fueron derivados para estudio de otra patología, 9 de ellos con otro cáncer en etapificación o seguimiento.Los tumores pesquisados fueron Ca pulmonar (2), Ca tiroides (2), meningioma (2), Ca páncreas (1), Ca colon (1), TMPI Páncreas (1), Ca endometrio (1), y Ca mama (1).La ocurrencia de neoplasia detectada incidentalmente en la población total fue de 4,4 por ciento (11/252 excluyendo PET/CT por control de tratamiento), y en la población oncológica de4,2 por ciento (9/216 excluyendo pacientes no oncológicos y PET/CT controles).En conclusión, el PET/CT es de gran utilidad en el estudio inicial y seguimiento de pacientes oncológicos, permitiendo además pesquisar un segundo tumor primario
PET/CT has been in the initial study follow-up of malignant tumors, shown optimal cost/benefit relation. The purpose of this study was to evaluate the occurrence of unexpected malignancies in patients who realize a PET/CT whole-body scan. Methodology: A total of 354 PET/CT scans were done from January 2009 to January 2010. The scans in which an unexpected malignancy was detected, that unrelated to the primary indication of exam, were recorded. Results: Eleven unexpected neoplasm were discovered in 11 patients, 9 of them with a known cancer in initial staging or follow-up. Tumors encountered were lung cancer (2), thyroid cancer (2), meningioma (2), pancreatic cancer (1), colon cancer (1), IPTM of the pancreas (1), endometrial cancer (1), and breast cancer (1).The occurrence of incidentally neoplasm in total group was 4,4 percent (11/252 excluding followup PET/CT scans 4,2 percent in oncologic population (9/216 excluding non oncologic patients and follow-up scans). In conclusion, PET/CT is a very helpful imaging procedure in the initial study and follow up of oncologic patients, allowing to detect a second primary malignancy
Subject(s)
Humans , Male , Female , Child , Middle Aged , Aged , Aged, 80 and over , Young Adult , Neoplasms, Multiple Primary/diagnostic imaging , Tomography, X-Ray Computed/methods , Mass Screening , Retrospective Studies , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Incidental Findings , Positron-Emission Tomography , Whole Body Imaging , Neoplasms/epidemiologyABSTRACT
Los quistes broncogénicos son alteraciones congénitas del árbol traqueo-bronquial y son, generalmente, un hallazgo incidental en radiográfias de tórax realizadas por rutinas donde se manifiestan como masas bien delimitadas, de bordes lisos, ubicadas cerca de la carina (1). En Tomografía Computada (TC) se presentan como masas esféricas de atenuación semejante al agua o a tejidos blandos (2). Cuando presentan densidad de tejidos blando a la diferenciación con otras lesiones puede ser completa y la Resonancia Magnética (RM) suele ser de gran ayuda. El aspecto en imagenología seccional es generalmente diagnóstico. Los autores presentan dos casos clínicos que demuestran el espectro de presentación de esta patología, uno pesquisado en TC y corroborado por RM y el segundo detectado Rx de tórax y confirmado en TC. Ambos fueron removidos quirúrgicamente
Subject(s)
Humans , Female , Adult , Middle Aged , Bronchogenic Cyst/congenital , Mediastinal Cyst , Scapula/physiopathology , Magnetic Resonance Spectroscopy , Bronchogenic Cyst/surgery , Bronchogenic Cyst , Radiography, Thoracic , Thoracoscopy , ThoracotomyABSTRACT
During the last decade, helical CT revolutionized diagnostic imaging. Advanced computational programs now available allow creation of automatic 3D model of the tracheobronchial tree, making possible endotracheal and bronchial navigation similar to real fibrobronchoscopy virtual bronchoscopy (VB) is useful in the study of fixed stenosis of the airway distal to the lesion, something that cannot always be achieved with real fibrobronchoscopy. VB can also show the adjacent mediastinal structures simultaneously represents a great advantage of this technique. If its use gives relevant information for patient management is something yet to demonstrate in prospective studies