Login Register Cart 0
Generic placeholder image

Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

FDG PET/CT in the Staging of Lung Cancer

Author(s): Mohsen Farsad*

Volume 13, Issue 3, 2020

Page: [195 - 203] Pages: 9

DOI: 10.2174/1874471013666191223153755

Abstract

Background: Accurate staging is crucial for the proper management of patients with nonsmall cell lung cancer, especially for choosing the best treatment strategy. Different Imaging methods are used to stage patients with non-small cell lung cancer. In the last two decades, FDG PET/CT is carried out in almost all the main Hospitals around the world in this setting.

Objective: The aim of this paper is to focus on the value of integrated FDG PET/CT in the TNM staging of the non-small cell lung cancer.

Methods: A non-systematic revision of the literature was performed in order to identify all papers about the role of FDG PET/CT in the evaluation of non-small cell lung cancer and to highlight the value of FDG PET/CT in this setting.

Results: Many data are now available about this topic, including also randomized controlled trials. FDG PET/CT is of limited added value in the characterization of T status but it increases the diagnostic accuracy for the assessment of the nodal status. The main advantage of FDG PET/CT over conventional imaging methods is its higher sensitivity in identifying extra-thoracic metastases, especially bone and adrenal lesions.

Conclusion: PET/CT with FDG should be included in the diagnostic work-up of patients with lung cancer, because it provides useful information for appropriate therapy.

Keywords: Lung cancer, PET/CT, FDG, staging, therapy, diagnostic workup, imaging.

« Previous Next »
Graphical Abstract

[1]
Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2018, 68(6), 394-424. Epub ahead of print
[http://dx.doi.org/10.3322/caac.21492] [PMID: 30207593]
[2]
American Cancer Society Key statistics for lung cancer; Available at, 2018. https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html
[3]
Goldstraw, P.; Chansky, K.; Crowley, J.; Rami-Porta, R.; Asamura, H.; Eberhardt, W.E.; Nicholson, A.G.; Groome, P.; Mitchell, A.; Bolejack, V. International association for the study of lung cancer staging and prognostic factors committee, advisory boards, and participating institutions; international association for the study of lung cancer staging and prognostic factors committee advisory boards and participating institutions. the iaslc lung cancer staging project: proposals for revision of the tnm stage groupings in the forthcoming (eighth) edition of the tnm classification for lung cancer. J. Thorac. Oncol., 2016, 11(1), 39-51.
[http://dx.doi.org/10.1016/j.jtho.2015.09.009] [PMID: 26762738]
[4]
Postmus, PE; Kerr, KM; Oudkerk, M 2017. Jul;1(suppl_4), iv1-iv21.
[5]
Kalemkerian, G.P.; Loo, B.W., Jr; Akerley, W.; Attia, A.; Bassetti, M.; Boumber, Y.; Decker, R.; Dobelbower, M.C.; Dowlati, A.; Downey, R.J.; Florsheim, C.; Ganti, A.K.P.; Grecula, J.C.; Gubens, M.A.; Hann, C.L.; Hayman, J.A.; Heist, R.S.; Koczywas, M.; Merritt, R.E.; Mohindra, N.; Molina, J.; Moran, C.A.; Morgensztern, D.; Pokharel, S.; Portnoy, D.C.; Rhodes, D.; Rusthoven, C.; Sands, J.; Santana-Davila, R.; Williams, C.C.; Hoffmann, K.G.; Hughes, M. NCCN guidelines Insights: small cell lung cancer, version 2.2018. J. Natl. Compr. Canc. Netw., 2018, 16(10), 1171-1182.
[http://dx.doi.org/10.6004/jnccn.2018.0079] [PMID: 30323087]
[6]
Fischer, B.; Lassen, U.; Mortensen, J.; Larsen, S.; Loft, A.; Bertelsen, A.; Ravn, J.; Clementsen, P.; Høgholm, A.; Larsen, K.; Rasmussen, T.; Keiding, S.; Dirksen, A.; Gerke, O.; Skov, B.; Steffensen, I.; Hansen, H.; Vilmann, P.; Jacobsen, G.; Backer, V.; Maltbaek, N.; Pedersen, J.; Madsen, H.; Nielsen, H.; Højgaard, L. Preoperative staging of lung cancer with combined PET-CT. N. Engl. J. Med., 2009, 361(1), 32-39.
[http://dx.doi.org/10.1056/NEJMoa0900043] [PMID: 19571281]
[7]
Maziak, DE; Darling, GE; Inculet, RI Positron emission tomography in staging early lung cancer: a randomized trial. Ann Intern Med,, 2009, 151, 221–8-W-48.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00132]
[8]
Viney, R.C.; Boyer, M.J.; King, M.T.; Kenny, P.M.; Pollicino, C.A.; McLean, J.M.; McCaughan, B.C.; Fulham, M.J. Randomized controlled trial of the role of positron emission tomography in the management of stage I and II non-small-cell lung cancer. J. Clin. Oncol., 2004, 22(12), 2357-2362.
[http://dx.doi.org/10.1200/JCO.2004.04.126] [PMID: 15197196]
[9]
Herder, G.J.; Kramer, H.; Hoekstra, O.S.; Smit, E.F.; Pruim, J.; van Tinteren, H.; Comans, E.F.; Verboom, P.; Uyl-de Groot, C.A.; Welling, A.; Paul, M.A.; Boers, M.; Postmus, P.E.; Teule, G.J.; Groen, H.J. POORT Study Group Traditional versus up-front [18F] fluorodeoxyglucose-positron emission tomography staging of non-small-cell lung cancer: a Dutch cooperative randomized study. J. Clin. Oncol., 2006, 24(12), 1800-1806.
[http://dx.doi.org/10.1200/JCO.2005.02.4695] [PMID: 16567772]
[10]
van Tinteren, H.; Hoekstra, O.S.; Smit, E.F.; van den Bergh, J.H.; Schreurs, A.J.; Stallaert, R.A.; van Velthoven, P.C.; Comans, E.F.; Diepenhorst, F.W.; Verboom, P.; van Mourik, J.C.; Postmus, P.E.; Boers, M.; Teule, G.J. Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet, 2002, 359(9315), 1388-1393.
[http://dx.doi.org/10.1016/S0140-6736(02)08352-6] [PMID: 11978336]
[11]
Spadafora, M.; Pace, L.; Evangelista, L.; Mansi, L.; Del Prete, F.; Saladini, G.; Miletto, P.; Fanti, S.; Del Vecchio, S.; Guerra, L.; Pepe, G.; Peluso, G.; Nicolai, E.; Storto, G.; Ferdeghini, M.; Giordano, A.; Farsad, M.; Schillaci, O.; Gridelli, C.; Cuocolo, A. Risk-related 18F-FDG PET/CT and new diagnostic strategies in patients with solitary pulmonary nodule: the ITALIAN multicenter trial. Eur. J. Nucl. Med. Mol. Imaging, 2018, 45(11), 1908-1914.
[http://dx.doi.org/10.1007/s00259-018-4043-y] [PMID: 29730697]
[12]
Downey, R.J.; Akhurst, T.; Gonen, M.; Vincent, A.; Bains, M.S.; Larson, S.; Rusch, V. Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection. J. Clin. Oncol., 2004, 22(16), 3255-3260.
[http://dx.doi.org/10.1200/JCO.2004.11.109] [PMID: 15310769]
[13]
Berghmans, T.; Dusart, M.; Paesmans, M.; Hossein-Foucher, C.; Buvat, I.; Castaigne, C.; Scherpereel, A.; Mascaux, C.; Moreau, M.; Roelandts, M.; Alard, S.; Meert, A.P.; Patz, E.F., Jr; Lafitte, J.J.; Sculier, J.P. European lung cancer working party for the iaslc lung cancer staging project. primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European lung cancer working party for the IASLC lung cancer staging project. J. Thorac. Oncol., 2008, 3(1), 6-12.
[http://dx.doi.org/10.1097/JTO.0b013e31815e6d6b] [PMID: 18166834]
[14]
Cheng, G.; Huang, H. Prognostic value of 18F-Fluorodeoxyglucose PET/computed tomography in non-small-cell lung cancer. PET Clin., 2018, 13(1), 59-72.
[http://dx.doi.org/10.1016/j.cpet.2017.08.006] [PMID: 29157386]
[15]
Kirienko, M.; Cozzi, L.; Rossi, A.; Voulaz, E.; Antunovic, L.; Fogliata, A.; Chiti, A.; Sollini, M. Ability of FDG PET and CT radiomics features to differentiate between primary and metastatic lung lesions. Eur. J. Nucl. Med. Mol. Imaging, 2018, 45(10), 1649-1660.
[http://dx.doi.org/10.1007/s00259-018-3987-2] [PMID: 29623375]
[16]
Schmidt-Hansen M1.; Baldwin, DR.; Hasler, E. PET-CT for assessing mediastinal lymph node involvement in patients with suspected resec-table non-small cell lung cancer. Cochrane Database Syst. Rev., 2014, NOV 13(11)
[17]
Gao, S.J.; Kim, A.W.; Puchalski, J.T.; Bramley, K.; Detterbeck, F.C.; Boffa, D.J.; Decker, R.H. Indications for invasive mediastinal staging in patients with early non-small cell lung cancer staged with PET-CT. Lung Cancer, 2017, 109, 36-41.
[http://dx.doi.org/10.1016/j.lungcan.2017.04.018] [PMID: 28577947]
[18]
Cerfolio, R.J.; Bryant, A.S.; Eloubeidi, M.A. Routine mediastinoscopy and esophageal ultrasound fine-needle aspiration in patients with non-small cell lung cancer who are clinically N2 negative: a prospective study. Chest, 2006, 130(6), 1791-1795.
[http://dx.doi.org/10.1378/chest.130.6.1791] [PMID: 17166998]
[19]
Maziuk, D.; Darling, G.E.; Inculet, R.I. A randomized controlled trial (RCT) of 18F-fluorodeoxyglucose (FDG) positron emission tomogra-phy (PET) versus conventional imaging (CI) in staging potentially resectable non-small cell lung cancer (NSCLC). J. Clin. Oncol., 2008, 26(Suppl.), 739s.
[http://dx.doi.org/10.1200/jco.2008.26.15_suppl.7502]
[20]
The diagnosis and treatment of lung cancer (CG121) Clinical Guidelines, 2011 April; Accessed April 25, 2011. Available at http://www.nice.org.uk/nicemedia/pdf/CG024niceguideline.pdf
[21]
Song, J.W.; Oh, Y.M.; Shim, T.S.; Kim, W.S.; Ryu, J.S.; Choi, C.M. Efficacy comparison between (18)F-FDG PET/CT and bone scintigraphy in detecting bony metastases of non-small-cell lung cancer. Lung Cancer, 2009, 65(3), 333-338.
[http://dx.doi.org/10.1016/j.lungcan.2008.12.004] [PMID: 19144446]
[22]
Ak, I.; Sivrikoz, M.C.; Entok, E.; Vardareli, E. Discordant findings in patients with non-small-cell lung cancer: absolutely normal bone scans versus disseminated bone metastases on positron-emission tomography/computed tomography. Eur. J. Cardiothorac. Surg., 2010, 37(4), 792-796.
[http://dx.doi.org/10.1016/j.ejcts.2009.11.011] [PMID: 20015657]
[23]
Qu, X.; Huang, X.; Yan, W.; Wu, L.; Dai, K. A meta-analysis of 18FDG-PET-CT, 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with lung cancer. Eur. J. Radiol., 2012, 81(5), 1007-1015.
[http://dx.doi.org/10.1016/j.ejrad.2011.01.126] [PMID: 21354739]
[24]
Boellaard, R.; Delgado-Bolton, R.; Oyen, W.J.; Giammarile, F.; Tatsch, K.; Eschner, W.; Verzijlbergen, F.J.; Barrington, S.F.; Pike, L.C.; Weber, W.A.; Stroobants, S.; Delbeke, D.; Donohoe, K.J.; Holbrook, S.; Graham, M.M.; Testanera, G.; Hoekstra, O.S.; Zijlstra, J.; Visser, E.; Hoekstra, C.J.; Pruim, J.; Willemsen, A.; Arends, B.; Kotzerke, J.; Bockisch, A.; Beyer, T.; Chiti, A.; Krause, B.J. European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur. J. Nucl. Med. Mol. Imaging, 2015, 42(2), 328-354.
[http://dx.doi.org/10.1007/s00259-014-2961-x] [PMID: 25452219]
[25]
Luketich, J.D.; Burt, M.E. Does resection of adrenal metastases from non-small cell lung cancer improve survival? Ann. Thorac. Surg., 1996, 62(6), 1614-1616.
[http://dx.doi.org/10.1016/S0003-4975(96)00611-X] [PMID: 8957360]
[26]
Ansquer, C.; Scigliano, S.; Mirallié, E.; Taïeb, D.; Brunaud, L.; Sebag, F.; Leux, C.; Drui, D.; Dupas, B.; Renaudin, K.; Kraeber-Bodéré, F. 18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation. Eur. J. Nucl. Med. Mol. Imaging, 2010, 37(9), 1669-1678.
[http://dx.doi.org/10.1007/s00259-010-1471-8] [PMID: 20490488]
[27]
Blake, M.A.; Slattery, J.M.; Kalra, M.K.; Halpern, E.F.; Fischman, A.J.; Mueller, P.R.; Boland, G.W. Adrenal lesions: characterization with fused PET/CT image in patients with proved or suspected malignancy--initial experience. Radiology, 2006, 238(3), 970-977.
[http://dx.doi.org/10.1148/radiol.2383042164] [PMID: 16505394]
[28]
Chong, S.; Lee, K.S.; Kim, H.Y.; Kim, Y.K.; Kim, B.T.; Chung, M.J.; Yi, C.A.; Kwon, G.Y. Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls. Radiographics, 2006, 26(6), 1811-1824.
[http://dx.doi.org/10.1148/rg.266065057] [PMID: 17102052]
[29]
Perri, M.; Erba, P.; Volterrani, D.; Guidoccio, F.; Lazzeri, E.; Caramella, D.; Mariani, G. Adrenal masses in patients with cancer: PET/CT characterization with combined CT histogram and standardized uptake value PET analysis. AJR Am. J. Roentgenol., 2011, 197(1), 209-216.
[http://dx.doi.org/10.2214/AJR.10.5342] [PMID: 21701032]
[30]
Boland, GW; Dwamena, BA Jagtiani Sangwaiya, M Characterization of adrenal masses by using FDG PET: a systematic review and metaanalysis of diagnostic,
[http://dx.doi.org/10.1148/radiol.11100569]
[31]
Gupta, N.C.; Rogers, J.S.; Graeber, G.M.; Gregory, J.L.; Waheed, U.; Mullet, D.; Atkins, M. Clinical role of F-18 fluorodeoxyglucose positron emission tomography imaging in patients with lung cancer and suspected malignant pleural effusion. Chest, 2002, 122(6), 1918-1924.
[http://dx.doi.org/10.1378/chest.122.6.1918] [PMID: 12475827]
[32]
Sun, Y.; Yu, H.; Ma, J.; Lu, P. The Role of 18F-FDG PET/CT integrated imaging in distinguishing malignant from benign pleural effusion. PLoS One, 2016, 11(8)e0161764
[http://dx.doi.org/10.1371/journal.pone.0161764] [PMID: 27560933]
[33]
Kim, B.S.; Kim, I.J.; Kim, S.J.; Pak, K.; Kim, K. Predictive value of F-18 FDG PET/CT for malignant pleural effusion in non-small cell lung cancer patients. Onkologie, 2011, 34(6), 298-303.
[PMID: 21625182]

Rights & Permissions Print Cite
Article Metrics
16
© 2024 Bentham Science Publishers | Privacy Policy