Saima Riaz, Humayun Bashir, Khalid Niazi Imran
Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Asia Ocean J Nucl Med Biol. 2017 Spring;5(2):109-113. doi: 10.22038/aojnmb.2017.8751.
Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma, which accounts for 10-15% of pulmonary cancers and exhibits early metastatic spread. This study aimed to determine the added value of F-FDG PET/CT imaging in tumor, node, and metastasis (TNM) staging of SCLC, compared to the conventional computed tomography (CT) scan and its potential role as a prognosticator.
This retrospective review was conducted on 23 patients, who were histopathologically diagnosed to have SCLC and referred for undergoing F-FDG PET/CT scanning during October 2009-December 2015. The rate of agreement between the CT and F-FDG PET/CT findings for TNM staging was calculated using the Cohen's kappa (κ). The median follow-up time was eight months, ranging 27-3 months). The overall and disease-free survival rates were calculated based on the extent of disease.
19 cases were male and four female with the mean age of 58±9 years. The F-FDG PET/CT identified limited and extensive diseases in 2 (8.7%) and 21 (91.3%) patients, respectively. In addition, the results of the Cohen's kappa demonstrated a strong (κ=0.82), fair (κ=0.24), and poor (κ=0.12) agreement between the PET/CT and CT findings for determining tumor, node, and metastasis stages, respectively. The F-FDG PET/CT scans upstaged disease in 47% of the cases with visceral and osseous metastasis. The disease-free survival rates for the limited and extensive diseases were 100% and 23% within the 12-month follow-up. In addition, 8 (35%) patients expired during the follow-up period.
Improved nodal and metastatic disease identification highlights the role of F-FDG PET/CT scanning in initial staging of SCLC with prognostic implications.
小细胞肺癌（SCLC）是一种侵袭性神经内分泌癌，占肺癌的10 - 15%，且早期即发生转移。本研究旨在确定F - FDG PET/CT成像在SCLC的肿瘤、淋巴结和转移（TNM）分期中相对于传统计算机断层扫描（CT）的附加价值及其作为预后指标的潜在作用。
对23例经组织病理学诊断为SCLC且在2009年10月至2015年12月期间接受F - FDG PET/CT扫描的患者进行回顾性研究。使用Cohen's kappa（κ）计算CT与F - FDG PET/CT在TNM分期结果上的一致性率。中位随访时间为8个月（范围27 - 3个月）。根据疾病范围计算总生存率和无病生存率。
19例男性，4例女性，平均年龄58±9岁。F - FDG PET/CT分别在2例（8.7%）和21例（91.3%）患者中识别出局限性和广泛性疾病。此外，Cohen's kappa结果显示，PET/CT与CT在确定肿瘤、淋巴结和转移分期方面的一致性分别为强（κ = 0.82）、中等（κ = 0.24）和差（κ = 0.12）。F - FDG PET/CT扫描使47%有内脏和骨转移的病例疾病分期上调。在12个月的随访中，局限性和广泛性疾病的无病生存率分别为100%和23%。此外，8例（35%）患者在随访期间死亡。
改进的淋巴结和转移疾病识别突出了F - FDG PET/CT扫描在SCLC初始分期中的作用，并具有预后意义。
