Sharma Rajnish, Tripathi Madhavi, D'Souza Maria, Jaimini Abhinav, Saw Sanjiv Kumar, Singh Dinesh, Mishra Anil, Mondal Anupam
Division of PET imaging, Molecular Imaging and Research Centre (MIRC), Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi-110054, India.
Hell J Nucl Med. 2009 Jan-Apr;12(1):22-5.
Lung cancer (LC) has an unfavorable prognosis especially when the disease is extensive at presentation. Accurate staging is therefore needed for treatment planning of these patients. In the present study the role of positron emission tomography/computerized tomography (PET/CT) in the detection of extra thoracic metastases in LC is being evaluated. In all 52 of our patients with stage IIIA or lower of LC disease, a whole body (18)F-FDG PET/CT was performed. All patients were also subjected to general clinical evaluation, chest X-rays and chest contrast enhanced CT (CECT) and were confirmed by histopathology or magnetic resonance imaging or radiology. Incidental extra thoracic malignant lesions were found by (18)F-FDG PET/CT in 9 out of the 52 patients (17.3%). No false positive lesions were found. As for the primary LC diagnosed by fine needle aspiration cytology (FNAC): (18)F-FDG PET/CT diagnosed all 52 cases, CECT detected 46 cases and chest X-rays detected 28 cases. The diagnostic accuracy was 100%, 92% and 53.8% respectively. As for the 9 cases with extrathoracic metastases diagnosed by (18)F-FDG PET/CT they were confirmed: by biopsy 6, by MRI 2 and by X-rays with or without biopsy 2. In conclusion, (18)F-FDG PET/CT had better diagnostic accuracy in diagnosing LC stage IIIA or lower, than CECT or chest X-rays. Extrathoracic metastases were high: 9/52 as diagnosed by (18)F-FDG PET/CT and standardized up take value.
肺癌（LC）的预后不佳，尤其是在疾病初发时已广泛扩散的情况下。因此，这些患者的治疗规划需要准确分期。在本研究中，正电子发射断层扫描/计算机断层扫描（PET/CT）在检测肺癌胸外转移方面的作用正在得到评估。我们纳入了所有52例ⅢA期或更低分期的肺癌患者，均进行了全身（18）F-FDG PET/CT检查。所有患者还接受了全面的临床评估、胸部X线检查和胸部增强CT（CECT），并通过组织病理学、磁共振成像或放射学检查进行确诊。52例患者中有9例（17.3%）通过（18）F-FDG PET/CT发现了意外的胸外恶性病变。未发现假阳性病变。对于通过细针穿刺细胞学检查（FNAC）诊断的原发性肺癌：（18）F-FDG PET/CT诊断出所有52例，CECT检测出46例，胸部X线检查检测出28例。诊断准确率分别为100%、92%和53.8%。对于通过（18）F-FDG PET/CT诊断出的9例胸外转移患者，确诊情况如下：6例通过活检确诊，2例通过MRI确诊，2例通过X线检查（有或无活检）确诊。总之，（18）F-FDG PET/CT在诊断ⅢA期或更低分期的肺癌方面，比CECT或胸部X线检查具有更高的诊断准确率。通过（18）F-FDG PET/CT和标准化摄取值诊断出的胸外转移率较高：9/52。
