J Nucl Med. 2007; 48 (Supplement 2):361P
Oncology: Clinical Diagnosis-Solid Tumors
Clinical Diagnosis-Solid Tumors Posters |
Contribution of FDG-PET in the detection of pulmonary lymphangitic carcinomatosis (PLC) in patients with primary lung carcinoma
Gunsel Acikgoz2,
Tevfik Cermik1,
Gonca Bural1,
Mohamed Houseni1 and
Abas Alavi1
1 Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; ;
2 Medical Imaging, Alfred I. Dupont Children Hospital, Wilmington, Delaware
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Objectives: The diagnosis of PLC is of great importance for the prognostically-oriented therapy stratification of lung cancer patients. The purpose of this study was to determine the value of FDG-PET in the detection and differentiation of PLC in patients with suspected of PLC on computed tomography (CT), and to identify the FDG uptake patterns of PLC. Methods: 26 patients (age: 43-90), who referred for FDG-PET for staging or restaging of known lung cancer and had evidence/suggestion of PLC on CT are included in this study: 6 patients with small cell carcinoma and 20 patients with nonsmall cell carcinoma (11 with adenocarcinoma, 4 with squamous cell carcinoma and 5 with poorly-differentiated non-small cell carcinoma). All PET scans were reviewed in conjunction with CT scans by 2 experienced readers and results were correlated with clinical data, including histological analysis or clinical and radiological follow up. The mean interval between CT and PET was 12.4 days (range: 0-36 day). PET was interpreted as positive if there was FDG uptake corresponding to suspected PLC areas on CT. Results: A final diagnosis of PLC was made in 22 patients based on histopathological examination and/or radiographic or clinical follow-up. In the remaining 4 patients, final diagnosis was pneumonia/pneumonitis in 2, athelectasis in 1, and lung edema in 1 subject. Of the 26 patients with suggestion of PLC on CT, PET showed corresponding increased FDG uptake in 22 pts: PET true positive in 20 (extensive-diffuse involvement in 11 and limited-local involvement in 9) and false positive in 2 (both with pneumonia/pneumonitis). There was no corresponding FDG uptake in 4 patients on PET: PET true negative in 2 (1 patient with lung edema and 1 patient with athelectasis) and false negative in 2 (both with only limited-local disease in lung base). In total of 26 pts with suspicion of PLC on CT, PET was useful in 22 patients (85%) by correctly confirming PLC in 20 pts and excluding PLC in 2 patients. Conclusions: FDG-PET is useful in confirming and excluding PLC in lung carcinoma patients with suspected PLC on CT. The distribution of PLC is limited-local in half of the cases.
