Background:
Lung cancer is the neoplasm with the highest prevalence and mortality rates in the world. Most
patients with lung cancer that are symptomatic have hemoptysis, coughing, shortness of breath, chest pain and persistent
infections. Less than 10% of patients are asymptomatic when the tumor is detected as an incidental finding.
Objective:
The present expert review aims to describe the use of radiological imaging modalities for the diagnosis of lung
cancer.
Methods:
Some papers were selected form the international literature, by using mainly Pubmed as source.
Results:
Chest x-ray (CXR) is the first investigation performed during the workup of a suspected lung cancer. In absence of a
rib erosion CXR cannot distinguish between benign from malignant masses, therefore computed tomography (CT) with
contrast enhancement should be performed in order to obtain a correct staging. Magnetic resonance imaging of chest is
considered a secondary approach because of the respiratory movement affects the overall results.
Conclusion:
Radiological imaging is essential for the management of patients affected by lung cancer.
Although PSSL is a rare tumour, a pulmonary mass of inhomogeneous density, associated with pleural effusion but without lymphadenopathy, detected in an asymptomatic or poorly symptomatic patient, should lead to PSSL being considered in the differential diagnosis, provided that metastases from the more common synovial sarcomas of the musculoskeletal system have been excluded.
BackgroundTo evaluate the role of computed tomography (CT) and positron emission tomography (PET)/CT in patients with thymic cancer and thymoma at initial staging.MethodsWe retrospectively reviewed CT and PET/CT scans of 26 patients with a thymic cancer (n = 9) or thymoma (n = 17). Chest CT findings documented were qualitative and quantitative. Both qualitative and semiquantitative data were recovered by PET/CT. The comparisons among histological entities, outcome, and qualitative data from CT and PET/CT were made by non-parametric analysis.ResultsPET/CT resulted positive in 15/17 patients with thymoma. CT was available in 5/9 (56%) patients with thymic cancer and in 3/17 with thymoma. All quantitative CT parameters were significantly higher in patients with thymic cancer than thymoma (maximum axial diameter: 45 vs. 20 mm, maximum longitudinal diameter: 69 vs. 21 mm and volume: 77.91 vs. 4.52 mL; all P < 0.05). Conversely, only metabolic tumor volume (MTV) and total lesion glycolysis were significantly different in patients with thymic cancer than thymoma (126.53 vs. 6.03 cm3 and 246.05 vs. 20.32, respectively; both P < 0.05). After a median follow-up time of 17.45 months, four recurrences of disease occurred: three in patients with thymic cancer and one with a type B2 thymoma. CT volume in patients with recurrent disease was 102.19 mL versus a median value of 62.5 mL in six disease-free patients. MTV was higher in the recurrent than disease-free patient subset (143.3 vs. 81.13 cm3), although not statistically significant (P = 0.075).ConclusionOur preliminary results demonstrated that both morphological and metabolic volume could be useful from a diagnostic and prognostic point of view in thymic cancer and thymoma patients. A large multi-center clinical trial experience for confirming the findings of this study seems mandatory.
FDG PET/CT appears useful in characterizing indeterminate lung nodules found at CECT scan in BC patients, with a sensitivity that is proportional to nodule size. In addition, PET/CT helped in avoiding over-treatment in a significant proportion of patients.
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