RESUMO
PURPOSE: To evaluate prognostic value of integrated 2-deoxy-2-[F-18]fluoro-D: -glucose-positron emission tomography/computed tomography (FDG-PET/CT) and correlate histopathological subtype with maximum standardized uptake value (SUV(max)) and survival in patients with malignant mesothelioma (MM). PROCEDURES: Retrospective review of FDG-PET/CT scans, with derivation of SUV(max) of FDG-avid lesions, was performed in patients with biopsy-proven MM. Clinical follow-up and Kaplan-Meier survival analysis was performed. RESULTS: Forty-six patients (37 M:9 F; mean age 61 years) with MM had a FDG-PET/CT scan in a 30-month period. Follow-up was available on 44/46 (96%) patients. Metastatic disease was detected in 9/46 (20%) patients on FDG-PET/CT, where 8/9 were previously undetected. Better survival was found in patients without metastases (p value < 0.05). Mean SUV(max) of primary pleural lesions in patients with metastatic disease was significantly higher than in patients without metastatic disease (p value < 0.05). Progression-free survival was significantly better in the epithelioid histology group compared to the biphasic group (p value 0.015). CONCLUSIONS: Detection of extrathoracic metastases on FDG-PET/CT and nonepithelioid histopathology are poor prognostic indicators in patients with MM.
Assuntos
Fluordesoxiglucose F18 , Mesotelioma/patologia , Neoplasias Pleurais/patologia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Intervalo Livre de Doença , Feminino , Fluordesoxiglucose F18/metabolismo , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Mesotelioma/diagnóstico por imagem , Pessoa de Meia-Idade , Neoplasias Pleurais/diagnóstico por imagem , Prognóstico , Radiografia , Compostos Radiofarmacêuticos/metabolismo , Fatores de TempoRESUMO
BACKGROUND: Accurate staging of lung cancer is essential in determining the most appropriate management plan, as detection of occult metastasis can significantly alter management. AIMS: The aims of this study are to determine the prevalence of occult metastasis in patients undergoing 2-(18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET) for evaluation of suspected/proven lung carcinoma and correlate pre-PET TNM stage with prevalence of metastasis. METHODS: FDG-PET, which identified patients with metastasis on institutional database, was re-evaluated by a nuclear medicine physician blinded to clinical information. The confidence level of metastasis was scored on a 5-point scale, with a score of >/=4 considered positive. RESULTS: There were 67 of 645 (10%) patients identified with suspected occult metastasis on FDG-PET. Twelve patients scoring
