The Use of Scan Pet for Lung Cancer
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 1
Abstract
Lung cancer is the most common cause of cancer death in Western countries, and non-small cell lung cancer (NSCLC) accounts for 80% of these neoplasms. Despite the efforts in the early diagnosis and advances in the treatment of these patients, overall survival remains very low, approximately 18% at 5 years2. The relatively low (30-50%) survival of patients with limited, potentially curable disease probably reflects the inability to detect advanced disease at initial staging. The stage of the disease is considered the most important prognostic factor and determines the therapeutic options. It is therefore crucial to perform a correct initial staging for the administration of an appropriate treatment, avoiding unnecessary surgeries. In this sense, the identification of contralateral mediastinal lymphatic involvement and distant metastasis is particularly relevant, since it classifies patients as stages IIIB and IV, excluding them from a curative treatment. Computed tomography (CT), the most widely used technique for evaluating patients with lung carcinoma, is based on morphological criteria and has limited accuracy for the diagnosis of tumor infiltration in normal-sized nodes, as well as detection of post treatment disease. Positron emission tomography (PET), on the other hand, provides valuable functional information in detecting metabolically active tumor cells before morphological changes occur and allows disease to be detected in clinically unsuspected locations. Currently, PET has become an important tool in the evaluation of lung cancer due to its high sensitivity in the detection of distant and lymph node metastases and has been incorporated into the protocols for preoperative staging of NMSC. The integration of CT and PET in the hybrid PET / CT system allows the acquisition in a single session of the anatomical and metabolic images, combining the benefits of both, while minimizing the limitations of each modality. In addition to the technical advantages involved9, it provides greater sensitivity and specificity than each of its components separately. For the evaluation of the solitary pulmonary nodule, PET and PET / CT are useful in the characterization of the solitary pulmonary nodule (NPS), since most malignant nodules show an increased glucose metabolism and, therefore, an increase in uptake of 18F-FDG. The metabolism of 18F-FDG in PET and PET / CT clinical studies can be assessed semi-quantitatively using the SUV index.
Authors and Affiliations
Daniela Vazquez Capdepon
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