Diagnosis of Pulmonary Metastases with Helical CT: The Effect of Imaging Techniques

Pfannschmidt, Joachim; Bischoff, Martin; Muley, T.; Kunz, J; Zámecnik, Patrik; Pa, Schnabel; Hoffmann, Henry; Dienemann, Hendrik; Cp, Heussel

doi:10.1055/s-2008-1038887

Cited by 30 publications

(18 citation statements)

References 9 publications

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“…Some researchers recommended sternotomy or thoracotomy1. Studies of these conventional procedures have found that the sensitivity of helical CT in detection of pulmonary metastatic lesions varies from 77% to 88.3% (Table 4)91416171819. The corresponding figure in our study was 63%.…”

Section: Discussionsupporting

confidence: 53%

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Long

Jiang

Yong-bin

et al. 2014

Sci Rep

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Hand-Assisted Thoracoscopic Surgery for pulmonary metastasectomy through sternocostal triangle access allows manual palpation of both lungs, thus permitting effective treatment of lung metastases. In our research, 62 patients from November 2001 to January 2012 underwent our Hand-Assisted Thoracoscopic Surgery procedures for pulmonary metastasectomy. Clinical data, including the number of pulmonary metastases determined by Computed Tomography/Positron Emission Tomography-Computed Tomography, surgical findings and survival data of these patients were collected. We found that the median follow-up time was 23.7 months (range 2.4 to 85.6 months). 30 cases of them had post-operative recurrences and the median disease-free survival period was 27.4 months. For Computed Tomography scan, the overall sensitivity for proved metastases was 63% (115/182). 67 non-imaged malignant nodules were palpated and removed in 14 cases. For Positron Emission Tomography-Computed Tomography scan, the overall sensitivity was 66% (79/120). 41 non-imaged malignant nodules were palpated and removed in 12 cases. This study show that the Hand-Assisted Thoracoscopic Surgery provides an easier way for routine bilateral pleural exploration, and thus is critical and effective in detection of non-imaged malignant pulmonary metastases, which might contribute to long-term disease-free survival.

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Section: Discussionsupporting

confidence: 53%

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Long

Jiang

Yong-bin

et al. 2014

Sci Rep

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“…Currently, computed tomography (CT) is used to detect recurrence; however, it has a high falsenegative rate for extrahepatic intra-abdominal lesions (e.g., para-aortic nodes) and a high false-positive rate for pulmonary lesions [9,10]. This disadvantage has led to the increased use of 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET)/CT as an imaging modality, in both preoperative assessment and during follow-up.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of 18F-FDG PET/CT in monitoring therapeutic response and detection of loco-regional recurrence and metastatic deposits of colorectal cancer in comparison to CT

Hetta

Niazi

Abdelbary

2020

Egypt J Radiol Nucl Med

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Background: The study shows the role of PET/CT in monitoring response to therapy in colorectal cancer as well as detection of loco-regional recurrence and metastatic deposits hence guiding the clinician to the proper management strategy. Sixty patients (41male and 19 female) were included in our study. All patients are pathologically proven colorectal cancer. They had undergone 18F-FDG PET/CT for follow up post-therapeutic (operative, and/or chemotherapy and/or radiotherapy) follow up for metastatic or recurrent colorectal cancer during the period from September 2015 to August 2017. Results: Our study demonstrated that FDG PET/CT is highly sensitive and specific in assessing local recurrence and distant metastasis in patient with pathologically proved colorectal cancer, with sensitivity 95.45%, specificity 97.3%, and accuracy 96.7% in detection of local recurrence; and sensitivity, specificity, and accuracy of 100% in detection of hepatic metastasis as well as in detection of nodal metastasis.Conclusion: FDG PET/CT is an accurate modality in the treatment plan of cancer colon in monitoring therapeutic response as well as defining their local extent and distant metastatic disease thus provides valuable information that is very helpful in the clinical decision-making process.

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“…Another way to increase detection is decreasing the slice thickness. Reducing the slice thickness from 5 mm to 3 mm results in a significant increase in the detection of lesions (7). It could be postulated that the identification of more lesions would limit the usefulness of bimanual lung palpation during operation, but with the decrease in sensitivity with smaller lesions, palpation may detect lesions missed by preoperative CT.…”

Section: Radiographic Diagnosis and Preoperative Imagingmentioning

confidence: 99%

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

Hengst¹,

Hendriks²,

Schil³

2012

Toraks Cer Bult

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Currently, surgical resection remains the gold standard for resectable lung metastases. Prognostic factors are histology, complete resection, number of metastases and disease-free interval. However, there is a high rate of recurrent disease in the thorax, even if systemic chemotherapy is applied. Because the latter is limited in dose due to systemic toxicity, new treatment options are being developed to selectively deliver high-dose chemotherapy into the lung, reducing systemic toxicity. Isolated lung perfusion (ILuP), similar to isolated limb perfusion, is an experimental surgical technique to deliver highdose chemotherapy into the lung without systemic exposure. Biological response modifiers like tumour necrosis factor can also be administered. ILuP results in significantly higher concentration of chemotherapy in the target organ compared to systemic chemotherapy, together with a survival benefit in experimental models of pulmonary metastases. Several phase I studies have shown that ILuP is technically feasible with low morbidity and low impact on the patient's pulmonary function. However, the utility of this technique is limited because it is an invasive technique. Other techniques to selectively deliver high-dose locoregional chemotherapy are embolic trapping (chemo-embolization), selective pulmonary artery perfusion (SPAP) without control of the venous effluent and the minimally invasive lung suffusion technique. This review will discuss surgical resection of lung metastases and address several techniques developed to deliver high doses of chemotherapy into the lung, as well as the current progress in experimental and clinical studies.

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Diagnosis of Pulmonary Metastases with Helical CT: The Effect of Imaging Techniques

Cited by 30 publications

References 9 publications

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Hand-Assisted Thoracoscopic Surgery for Pulmonary Metastasectomy through Sternocostal Triangle Access: Superiority in Detection of Non-Imaged Pulmonary Nodules

Accuracy of 18F-FDG PET/CT in monitoring therapeutic response and detection of loco-regional recurrence and metastatic deposits of colorectal cancer in comparison to CT

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

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