Soumia Fdil, Leila Achachi, Mohamed Raoufi, Laila Herrak, Mustapha Elftouh
Service de Pneumologie, Faculté de Médecine et de Pharmacie, Université Mohammed V, CHU Ibn Sina, Rabat, Maroc.
Pan Afr Med J. 2017 Dec 4;28:289. doi: 10.11604/pamj.2017.28.289.13130. eCollection 2017.
Bronchopulmonary cancer is a real public health problem. Morphological imaging plays a central role in its diagnosis, staging as well as post-therapeutic assessment but it has some limitations. Metabolic imaging is a more recent technique which allows to significantly improve the overall imagery performance. We conducted a retrospective, descriptive and analytical study at the Ibn Sina Hospital and at the Military Hospital of instruction Mohammed V in Rabat over a period of 18 months, between September 2014 and February 2016, in order to evaluate the role of Fluorodeoxyglucose-PET/CT in the staging and restaging of non-small cell bronchopulmonary cancer. Initial staging showed a vast majority of locally advanced and metastatic stages: stage IV (40%), Stage IIIB (36%), Stage IIIA (16%), Stage II (8%). PET-CT allowed to detect new sites which were not initially seen on CT scan in 24 cases: 15 new ganglion sites, 8 new adrenal sites and 6 sites of bone lesions. PET/CT allowed to modify initial tumor stage in 60% of cases: upstaging in 23 patients (46%) and downstaging in 7 patients(14%). The initial stage remained unchanged in 40% of patients. Our study confirms the data from the literature concerning the superiority of PET-CT in comparison with CT scan, but only in the optimization of the non-small cell bronchopulmonary cancer management, in particular in locoregional and distant staging.
支气管肺癌是一个切实存在的公共卫生问题。形态学成像在其诊断、分期以及治疗后评估中发挥着核心作用,但它存在一些局限性。代谢成像则是一项更新的技术,能显著提高整体成像性能。我们于2014年9月至2016年2月期间,在拉巴特的伊本·西那医院和穆罕默德五世军事教学医院开展了一项为期18个月的回顾性、描述性和分析性研究,旨在评估氟脱氧葡萄糖 - PET/CT在非小细胞支气管肺癌分期及再分期中的作用。初始分期显示绝大多数为局部晚期和转移期:IV期(40%)、IIIB期(36%)、IIIA期(16%)、II期(8%)。PET - CT在24例患者中检测到了CT扫描最初未发现的新部位:15个新的淋巴结部位、8个新的肾上腺部位和6个骨病变部位。PET/CT在60%的病例中改变了初始肿瘤分期:23例患者(46%)分期上调,7例患者(14%)分期下调。40%的患者初始分期保持不变。我们的研究证实了文献中关于PET - CT相较于CT扫描具有优越性的数据,但仅在优化非小细胞支气管肺癌的管理方面,特别是在局部区域和远处分期方面。