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Incidence of skeletal muscle metastases from non-small cell lung cancer

¹ MD Anderson Cancer Center, Houston, Texas; ² University of Alberta, Edmonton, Alberta, Canada

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Objectives: Determine frequency of skeletal muscle metastases (SMM) as found by routine PET/CT studies and describe their appearance on these images.

Methods: 2D PET imaging was performed 1 hour after IV administration of F18-labeled FDG. Non-contrast CT was performed from the top of the skull through the proximal thighs. Included patients had NSCLC and received initial staging or routine re-staging PET/CT investigations at our cancer hospital between 19 May 2006 and 19 Oct 2006. Reports of the patients’ PET/CT studies were reviewed for any mention of potential SMM. The PET/CT images, other imaging studies, and medical record for patients with potential SMM were further evaluated to confirm SMM and describe their appearance.

Results: 433 patients with NSCLC had PET/CT studies at our institution during the selected timeframe. Reports from 42 (9.7%) contained language that raised suspicion for SMM. After reviewing the images and medical records, 7 patients (1.6%) had at least 1 SMM. SMM were first discovered by CT of the abdomen in 1 and by PET/CT in 5 patients. Of these 5 patients, 3 lesions were missed on preceding contrast CT studies but visible in retrospect. Discovery of the SMM affected management in one case. The final SMM was missed by PET/CT reporting but was picked up for this study on investigation of other findings. On PET/CT, the SMM was a round area of increased activity in 6 cases and was fusiform in 1 case. SMM were nearly invisible on non-contrast CT.

Conclusions: An incidence of 1.6% of SMM on routine PET/CT evaluation indicates that SMM, though less common than many other sites, are not rare in patients with NSCLC. PET/CT is a relatively sensitive modality for their discovery. SMM may result in upstaging of tumors and may change management.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Wong, J. Articles by Haygood, T. PubMed Articles by Wong, J. Articles by Haygood, T.