Tomografia por emissão de pósitrons com 18F fluordesoxiglicose como exame não invasivo para o diagnóstico de sarcomas primários de artéria pulmonar

Dias, Olívia Meira; Lombardi, Elisa Maria Siqueira; Canzian, Mauro; Júnior, José Soares; Vieira, Lucas de Oliveira; Filho, Mário Terra

doi:10.1590/s1806-37132011000600017

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…Chest radiography findings are not specific to PAS ( 22 ). Although CT provides more information on the anatomy of the intravascular process, it cannot easily differentiate between PE and PAS ( 2 22 23 ). CT findings that favour PAS diagnosis include a heterogeneous enhancement of the mass occupying the main or the proximal pulmonary artery, and extravascular spread of the lesion ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Ventilation/perfusion scintigraphy is used for assessing the likelihood of PE but it is not helpful for distinguishing PAS from thromboembolic disease ( 31 32 ). 18FDG-PET plays an important role in the evaluation of pleuropulmonary neoplasms( 2 23 ) and is a non-invasive method for differential diagnosis of diseases showing a contrast-filling defect in the pulmonary artery by CT angiography, as blood thrombi do not take up 18F-FDG but malignant tumours such as PAS do ( 2 23 33 34 ). In our study, malignancy was preoperatively suspected in 12/17 patients on the basis of PET (sensitivity 70%) and 9/10 patients on MRI (sensitivity 90%).…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics and Treatment Outcomes of Primary Pulmonary Artery Sarcoma in Korea

et al. 2016

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Pulmonary artery sarcomas (PAS) are rare malignant neoplasms. Right heart failure due to tumour location is the main cause of death in PAS patients. The hemodynamic influence of PAS may effect prognosis, but this has not been proven. We aimed to identify the clinical characteristics and prognostic factors of PAS in Korea, their association with pulmonary hypertension (PH). PAS patients treated at the Asan Medical Center between 2000 and 2014 were reviewed. We examined demographic characteristics, diagnostic and treatment modalities. Potential prognostic factors were evaluated by univariate and multivariate analysis. Twenty patients were diagnosed with PAS. Ten patients were male, the median age was 54 years (range, 33–75 years). The most common symptom observed was dyspnea (65%). The most common histologic type was spindle cell sarcoma (30%). Ten patients had a presumptive diagnosis of pulmonary embolism (PE) and received anticoagulation therapy. Seventeen patients underwent surgery, but only 5 patients had complete resection. Eleven patients received post-operative treatment (chemotherapy = 3, radiotherapy = 5, chemoradiotherapy = 3). PH was observed in 12 patients before treatment and in 6 patients after treatment. Overall median survival was 24 months. Post-treatment PH was associated with poor prognosis (HR 9.501, 95% CI 1.79–50.32; P = 0.008) while chemotherapy was negatively associated with mortality (HR 0.102, 95% CI 0.013–0.826; P = 0.032) in univariate analysis. Post-treatment PH was also associated with poor prognosis in multivariate analysis (HR 5.7, 95% CI 1.08–30.91; P = 0.041). PAS patients are frequently misdiagnosed with PE in Korea. Post-treatment PH is associated with a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes of Primary Pulmonary Artery Sarcoma in Korea

et al. 2016

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“…[67] According to the several case reports of FDG-PET, blood thrombi showed negative FDG uptake; whereas, a malignant tumor such as sarcoma showed positive FDG uptake. [89] FDG-PET may show intense tracer activity within a PAS. While, some tracer activity within a thromboembolic disease may occur, intense tracer localization within a central pulmonary arterial filling defect strongly suggests primary pulmonary arterial malignancy.…”

Section: Discussionmentioning

confidence: 99%

Spindle cell sarcoma of pulmonary artery mimicking thromboembolism with lung metastasis detected in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

et al. 2014

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Pulmonary artery sarcoma (PAS), although rare, must be considered in the differential diagnosis of pulmonary thromboembolism (PTE). This tumor is highly malignant and the prognosis is very poor. As much as the standardized uptake values (SUVs) at fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) have helped in differentiating between benign and malignant tumors, visualization of a low-attenuation filling defect within a pulmonary artery on contrast-enhanced chest computed tomography (CT) can be suggestive of a malignancy, such as PAS, if the lesion shows high FDG uptake at PET. We present a case of PAS that showed high FDG uptake on integrated FDG PET/CT and with lung metastasis. Patient underwent endoscopic bronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA), which confirmed spindle cell sarcoma.

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“…With the development and dissemination of PET/CT, the functional tools gained more prominence over the last years ( 16 ) . This method allowed for the recognition of regions avid for glucose and its molecular analogues such as fluorodeoxyglucose (18 FDG) ( Figure 1 ) ( 17 ) . Such regions may correspond to sites of tumor involvement and their evaluation as a whole by conventional morphological imaging methods such as CT and MRI provides greater anatomical detail, improving the quality of the information and the management of the patients ( 18 - 20 ) .…”

Section: Advances In Oncologymentioning

confidence: 99%

Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

et al. 2015

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Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

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Tomografia por emissão de pósitrons com 18F fluordesoxiglicose como exame não invasivo para o diagnóstico de sarcomas primários de artéria pulmonar

Cited by 10 publications

References 13 publications

Clinical Characteristics and Treatment Outcomes of Primary Pulmonary Artery Sarcoma in Korea

Clinical Characteristics and Treatment Outcomes of Primary Pulmonary Artery Sarcoma in Korea

Spindle cell sarcoma of pulmonary artery mimicking thromboembolism with lung metastasis detected in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

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