ROLE OF PET-CT IMAGING IN STAGING OF BRONCHOGENIC CARCINOMA
Islam Mohamed Sameh Ebrahim;
Abstract
Bronchogenic carcinoma is a leading cause of cancer-related death in both men and women. Lung cancer has a high mortality rate, so early diagnosis provides the best chance for survival.
Lung cancer is divided into: small-cell lung cancer and non–small cell lung cancer which is the most common form of all bronchogenic carcinomas, and is furtherly classified into specific cell types from which the most common types are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Our study involved 91 patients (79 male and 12 female) with age range 37-90 (average 58). All patients were biopsy proved bronchogenic carcinoma and referred for PET-CT scans for initial staging to start the treatment plan.
Our data and in agreement with the previous studies has demonstrated that PET/CT is a valuable diagnostic tool for patients with bronchogenic carcinoma in the initial staging of the disease process as pretreatment proper staging determines the extent of disease and helps to differentiate operable from in-operable cases to avoid the morbidity of unuseful operations.
PET-CT has the following advantages:-
1. Better assessment of the extension of the primary tumor.
2. Better differentiation between benign and malignant pleural effusion.
3. Ability to detect small neoplastic activity within normal sized nodes and differentiation of enlarged hyperplastic nodes from enlarged neoplastic nodes. However, false positive lymph nodes, due to inflammatory process as tuberculosis, can occur. So, PET-CT is better to be used as a good negative tool.
4. High ability to detect distant metastases .The use of whole-body PET/CT scanning may be used as an alternative method to multiple scans and thus facilitates the survey of a much larger area than is possible with commonly used radiographic methods to detect distant metastasis. PET is better in detecting adrenal, liver and bone metastases but deficient in detecting brain metastases due to the high physiological uptake of the cerebral grey matter.
PET-CT has the following disadvantages:-
5- High cost of the examination.
6- Radiation exposure
7- False positive results with acute inflammation and severe infection.
The use of diagnostic contrast enhanced CT with PET/CT, although it expose the patients for more radiation risks, it helps in better anatomical localization, better assessment of the hepatic focal lesions and in addition it constitute a base line exam for further response assessment and follow up if PET/CT is not affordable and only CT will be used.
Finally, combined PET/CT using 18F-FDG is a better imaging modality than CT alone with valuable role in the initial staging of bronchogenic carcinoma.
Lung cancer is divided into: small-cell lung cancer and non–small cell lung cancer which is the most common form of all bronchogenic carcinomas, and is furtherly classified into specific cell types from which the most common types are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Our study involved 91 patients (79 male and 12 female) with age range 37-90 (average 58). All patients were biopsy proved bronchogenic carcinoma and referred for PET-CT scans for initial staging to start the treatment plan.
Our data and in agreement with the previous studies has demonstrated that PET/CT is a valuable diagnostic tool for patients with bronchogenic carcinoma in the initial staging of the disease process as pretreatment proper staging determines the extent of disease and helps to differentiate operable from in-operable cases to avoid the morbidity of unuseful operations.
PET-CT has the following advantages:-
1. Better assessment of the extension of the primary tumor.
2. Better differentiation between benign and malignant pleural effusion.
3. Ability to detect small neoplastic activity within normal sized nodes and differentiation of enlarged hyperplastic nodes from enlarged neoplastic nodes. However, false positive lymph nodes, due to inflammatory process as tuberculosis, can occur. So, PET-CT is better to be used as a good negative tool.
4. High ability to detect distant metastases .The use of whole-body PET/CT scanning may be used as an alternative method to multiple scans and thus facilitates the survey of a much larger area than is possible with commonly used radiographic methods to detect distant metastasis. PET is better in detecting adrenal, liver and bone metastases but deficient in detecting brain metastases due to the high physiological uptake of the cerebral grey matter.
PET-CT has the following disadvantages:-
5- High cost of the examination.
6- Radiation exposure
7- False positive results with acute inflammation and severe infection.
The use of diagnostic contrast enhanced CT with PET/CT, although it expose the patients for more radiation risks, it helps in better anatomical localization, better assessment of the hepatic focal lesions and in addition it constitute a base line exam for further response assessment and follow up if PET/CT is not affordable and only CT will be used.
Finally, combined PET/CT using 18F-FDG is a better imaging modality than CT alone with valuable role in the initial staging of bronchogenic carcinoma.
Other data
| Title | ROLE OF PET-CT IMAGING IN STAGING OF BRONCHOGENIC CARCINOMA | Other Titles | دور التصوير الطبقى بالبوزيترون المنبعث المدمج مع الأشعة المقطعية فى تحديد مراحل سرطان الرئة | Authors | Islam Mohamed Sameh Ebrahim | Issue Date | 2016 |
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