High rate of detection of unsuspected distant metastases by PET in apparent Stage III non–small-cell lung cancer: implications for radical radiation therapy

Manus, Michael P. Mac; Hicks, Rodney J.; Matthews, Jane P.; Hogg, Annette; McKenzie, A L; Wirth, Andrew; Ware, Robert E.; Ball, David

doi:10.1016/s0360-3016(01)01477-8

Cited by 263 publications

(48 citation statements)

References 19 publications

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“…These 13 patients included 2 with brain metastasis, 6 with pleural invasion and multiple bone metastasis, 2 with contralateral internal lung metastasis and pleural invasion, and 3 with only multiple bone metastasis. Other (36,37). Our study suggested that 99m Tc-octreotide scintigraphy was also valuable for the detection of distant metastatic disease, which led to further diagnostic investigation.…”

Section: Discussionmentioning

confidence: 51%

Role of 99mTc-Octreotide Acetate Scintigraphy in Suspected Lung Cancer Compared with 18F-FDG Dual-Head Coincidence Imaging

Wang¹,

Wang²,

Yao³

et al. 2007

Journal of Nuclear Medicine

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The aim of this study was to evaluate the clinical value of tomographic 99m Tc-octreotide acetate (hereafter, 99m Tc-octreotide) scintigraphy in the detection of patients with suspected lung cancer in comparison with that of 18 F-FDG dual-head coincidence imaging (DHC). Methods: Forty-four consecutive patients with suspected pulmonary neoplasms underwent tomographic 99m Tc-octreotide scintigraphy and 18 F-FDG coincidence imaging using the same gantry. The region of interest was drawn on the entire primary lesion. The tumor-to-normal tissue tracer values for both 99m Tc-octreotide and 18 F-FDG were determined using region of interests and expressed as T/N r and T/N m , respectively. Final diagnosis was confirmed by histopathologic analysis or clinical follow-up. Results: Thirty-one of the 44 patients had lung cancer-6 with small cell lung cancer (SCLC) and 25 with non-small cell lung cancer (NSCLC). Thirteen of the 44 patients had benign lung lesions. The sensitivity, specificity, positive predictive value, and negative predictive value of 99m Tc-octreotide were 100%, 75.7%, 90.1%, and 100%, respectively, and of 18 F-FDG DHC were 100%, 46.1%, 83.8%, and 100%, respectively. In the 31 patients with malignant tumors, all 38 abnormal lymph nodes in 20 patients showed abnormal high focal uptake of 18 F-FDG; only 7 patients with 10 regional lymph adenopathies showed moderate uptake of 99m Tc-octreotide. Thirteen patients with 39 distant sites of abnormal uptake visualized (imaging stage IV) with 99m Tc-octreotide included 2 patients with brain metastases, 6 patients with pleural invasion and multiple bone metastasis, 2 patients with contralateral internal lung metastasis and pleural invasion, and 3 patients with only multiple bone metastasis. The final diagnosis was confirmed by histopathology or clinical follow-up. Conclusion: The sensitivity of 99m Tc-octreotide for the detection of lung cancer at the primary lesion was comparable with that of 18 F-FDG coincidence imaging. Tomographic 99m Tc-octreotide scintigraphy had lower sensitivity for the detection of hilar and mediastinal lymph node metastasis compared with that of 18 F-FDG coincidence PET, but it had high sensitivity for the detection of remote metastatic lesions. However, because of the small population, further investigation is necessary.

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Section: Discussionmentioning

confidence: 51%

Role of 99mTc-Octreotide Acetate Scintigraphy in Suspected Lung Cancer Compared with 18F-FDG Dual-Head Coincidence Imaging

Wang¹,

Wang²,

Yao³

et al. 2007

Journal of Nuclear Medicine

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“…The probability that PET imaging will detect unsuspected distant metastasis in patients previously staged with CT increases with increasing AJCC stage group. In a study of 167 patients with apparent stage I-III NSCLC, PET-detected metastasis increased with increasing pre-PET stage from I (7.5%) through II (18%) to III (24%, P=0.016), and, in particular, was significantly higher in Stage III (P=0.039) (26).…”

Section: Detection Of Distant Extracranial Metastasismentioning

confidence: 98%

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

MacManus

Everitt

Schimek-Jasch

et al. 2017

Transl. Lung Cancer Res.

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This article reviews key imaging modalities for lung cancer patients treated with radiation therapy (RT) and considers their actual or potential contributions to critical decision-making. An international group of researchers with expertise in imaging in lung cancer patients treated with RT considered the relevant literature on modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). These perspectives were coordinated to summarize the current status of imaging in lung cancer and flag developments with future implications.Although there are no useful randomized trials of different imaging modalities in lung cancer, multiple prospective studies indicate that management decisions are frequently impacted by the use of complementary imaging modalities, leading both to more appropriate treatments and better outcomes. This is especially true of 18 F-fluoro-deoxyglucose (FDG)-PET/CT which is widely accepted to be the standard imaging modality for staging of lung cancer patients, for selection for potentially curative RT and for treatment planning. PET is also more accurate than CT for predicting survival after RT. PET imaging during RT is also correlated with survival and makes response-adapted therapies possible. PET tracers other than FDG have potential for imaging important biological process in tumors, including hypoxia and proliferation. MRI has superior accuracy in soft tissue imaging and the MRI Linac is a rapidly developing technology with great potential for online monitoring and modification of treatment. The role of imaging in RT-treated lung cancer patients is evolving rapidly and will allow increasing personalization of therapy according to the biology of both the tumor and dose limiting normal tissues.

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“…As far as the adrenal is concerned, most of the studies reported have dealt with the potential role of FDG-PET in the staging of patients with known extra-adrenal cancers (8,83,84). It has been well documented that FDG-PET provides a greater sensitivity than traditional radiologic imaging (8,72,80,(82)(83)(84)(85).…”

Section: Clinical Applications Of Fdg-petmentioning

confidence: 99%

Functional scintigraphy of the adrenal gland

et al. 2002

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Over the last 30 years nuclear medicine imaging of the adrenal gland and its lesions has been achieved by the exploitation of a number of physiological characteristics of this organ. By seeking and utilising features which are quantitatively or qualitatively different from those of the adjacent tissues, functional depiction of the adrenal gland and its diseases, which in most cases retain the basic physiology of their tissue of origin, including both the cortex and the medulla, are now a useful clinical reality. Agents widely used in clinical practice include: (a) uptake and storage of radiolabelled cholesterol analogues via the low density lipoprotein (LDL) receptor and cholesterol ester storage pool in the adrenal cortex ( 131 I-6-b-iodomethyl-norcholesterol, 75 Se-selenomethyl-norcholesterol); (b) catecholamine type I, presynaptic, uptake mechanism and intracellular granule uptake and storage mechanism in the adrenal medulla and extra-adrenal paraganglia ( 131 I-, 123 I-and 124 Imeta-iodo-benzyl-guanidine (MIBG), 18 F-metafluoro-benzyl-guanidine); (c) cell surface receptor binding of peptides/neurotransmitters/modulators such as for the family of five subtypes of somatostatin receptors ( 123 I-tyr-octreotide, 111 In-DTPA-octreotide, 111 In-DOTA-octreotide and many others); (d) although not specific for the adrenal gland, increased glycolysis by tumours, particularly the most malignant varieties, 18 F-2-fluoro-D-deoxyglucose can thus be expected to depict certain malignant lesions such as malignant pheochromocytomas (particularly the minority which are not detected by MIBG) and adrenal incidentalomas (particularly when they occur in patients with known extraadrenal malignancies). There are a variety of adrenal tissue characteristics with potential for exploitation but which are not currently in clinical use, and which may, nevertheless, have potential as imaging agents. These include: (a) inhibitors of adrenal cortical steroid hormone synthesis enzymes (e.g. radiolabelled analogues of metyrapone); (b) radiolabelled lipoproteins which bind to adrenocortical LDL receptors; (c) inhibitors of catecholamine biosynthesis enzymes (e.g. radiolabelled analogues of tyrosine and related amino acids); (d) cell surface receptors for various peptides and hormones which may be overexpressed on adrenal cortical or adrenal medullary tumours (e.g. radiolabelled analogues of ACTH on adrenocortical cells of zona fasciculata or zona glomerulosa origin, neurotransmitter/hormone message peptides binding to cell surface receptors such as bombesin, vasoactive intestinal polypeptide, cholecystokinin and opiate peptides); (e) the adrenal cortex can also synthesise cholesterol ab initio from acetate, and preliminary studies with 11 C-acetate positron emission tomography have shown interesting results. European Journal of Endocrinology 147 13-28 Adrenal cortexThe adrenal cortex is constituted of three layers. The outer layer, the glomerulosa zone, produces mineralocorticoids (mainly aldosterone) under the control of the renin -a...

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High rate of detection of unsuspected distant metastases by PET in apparent Stage III non–small-cell lung cancer: implications for radical radiation therapy

Cited by 263 publications

References 19 publications

Role of 99mTc-Octreotide Acetate Scintigraphy in Suspected Lung Cancer Compared with 18F-FDG Dual-Head Coincidence Imaging

Role of 99mTc-Octreotide Acetate Scintigraphy in Suspected Lung Cancer Compared with 18F-FDG Dual-Head Coincidence Imaging

Anatomic, functional and molecular imaging in lung cancer precision radiation therapy: treatment response assessment and radiation therapy personalization

Functional scintigraphy of the adrenal gland

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