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Küçük Hücreli Akciğer Kanserinin Beyin Metastazlarının 18F-FDG PET/CT'deki Görünümleri

Year 2022, Volume: 32 Issue: 3, 272 - 275, 01.08.2022
https://doi.org/10.54005/geneltip.1073349

Abstract

Amaç: Çalışmamızda, küçük hücreli akciğer kanserinin (KHAK) beyin manyetik rezonans görüntüleme (MRG) ile tespit edilen beyin metastazlarının (BM'ler) 18Fluor-Florodeoksiglukoz (18F-FDG) pozitron emisyon tomografisi/bilgisayarlı tomografisindeki (PET/BT) görünümlerini değerlendirdik.
Hastalar ve yöntem: Çalışmaya ilk evreleme amacıyla 30 gün içinde 18F-FDG PET/CT taraması ve beyin MRG'si olan SCLC hastaları dahil edildi. Beyin metastazlarını saptamak için MRG kullanıldı. BM'lerin 18F-FDG PET/BT üzerindeki görüntüleme bulguları değerlendirildi. 18F-FDG PET/BT çalışmasında BM'ler; saptanamayan, hipometabolik, hipermetabolik veya karışık (hem hipermetabolik hem de hipometabolik kısımları olan lezyonlar) paternler olarak sınıflandırıldı.
Bulgular: Çalışmaya yaş ortalaması 62.57 ± 9.64 olan 48'i (%94.1) erkek, 3'ü (%5.9) kadın; toplam 51 hasta dahil edildi. Hastaların 15'i (%29,4) sınırlı evredeyken, 36'sı (%69,6) yaygın evredeydi. 11 kişide, beyin MRG 28 BM gösterdi. 18F-FDG PET/BT'de 28 metastazın 13'ü görüldü. 18F-FDG PET/BT'deki BM görünümleri şunlardı: hipometabolik (n: 4), hipermetabolik (n: 6) ve karışık (n: 3). 18F-FDG PET/BT'de saptanan BM'lerin ortalama çapı 16mm iken; saptanamayanların ortalama çapı 4,3 mm idi.
Sonuç: 18F-FDG PET/BT'de BM'ler hipometabolik, hipermetabolik ve karışık paternler dahil olmak üzere çeşitli görünümlere sahip olabilir. Öte yandan, 18F-FDG PET/BT ile milimetrik boyutlu BM'lerin saptanamaması evrelemenin düzgün yapılmasını engellemektedir.

References

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  • 2. Rittberg R, Banerji S, Kim JO, Rathod S, Dawe DE. Treatment and Prevention of Brain Metastases in Small Cell Lung Cancer. Am J Clin Oncol 2021; 44(12): 629-38. 2021/10/11. doi: 10.1097/coc.0000000000000867.
  • 3. Hochstenbag MM, Twijnstra A, Wilmink JT, Wouters EF, ten Velde GP. Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC): MR-imaging is useful at initial diagnosis. J Neurooncol 2000; 48(3): 243-8. 2000/12/02. doi: 10.1023/a:1006427407281.
  • 4. Lu YY, Chen JH, Liang JA et al. 18F-FDG PET or PET/CT for detecting extensive disease in small-cell lung cancer: a systematic review and meta-analysis. Nucl Med Commun 2014; 35(7): 697-703. 2014/04/04. doi: 10.1097/mnm.0000000000000122.
  • 5. Vinjamuri M, Craig M, Campbell-Fontaine A, et al. Can positron emission tomography be used as a staging tool for small-cell lung cancer? Clin Lung Cancer 2008; 9(1): 30-4. 2008/02/20. doi: 10.3816/CLC.2008.n.005.
  • 6. Palomar Muñoz A, García Vicente AM, Bellón Guardia ME, et al. Is a selective brain (18)F-FDG PET/CT study profitable in patients with small cell lung cancer? Rev Esp Med Nucl Imagen Mol 2012; 31(3): 124-9. 2011/07/05. doi: 10.1016/j.remn.2011.05.002.
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  • 10. Brink I, Schumacher T, Mix M, et al. Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer. Eur J Nucl Med Mol Imaging 2004; 31(12): 1614-20. 2004/07/20. doi: 10.1007/s00259-004-1606-x.
  • 11. Hjorthaug K, Højbjerg JA, Knap MM, et al. Accuracy of 18F-FDG PET-CT in triaging lung cancer patients with suspected brain metastases for MRI. Nucl Med Commun 2015; 36(11): 1084-90. 2015/08/25. doi: 10.1097/mnm.0000000000000371.
  • 12. Zimmer L, Luxen A. PET radiotracers for molecular imaging in the brain: past, present and future. Neuroimage 2012; 61(2): 363-70. 2012/01/10. doi: 10.1016/j.neuroimage.2011.12.037.
  • 13. Fink KR, Fink JR. Imaging of brain metastases. Surg Neurol Int 2013; 4(Suppl 4): S209-19. 2013/05/30. doi: 10.4103/2152-7806.111298.
  • 14. Kitajima K, Nakamoto Y, Okizuka H, et al. Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors. Ann Nucl Med 2008; 22(7): 595-602. 2008/08/30. doi: 10.1007/s12149-008-0145-0.
  • 15. Juhász C, Dwivedi S, Kamson DO, Michelhaugh SK, Mittal S. Comparison of amino acid positron emission tomographic radiotracers for molecular imaging of primary and metastatic brain tumors. Mol Imaging 2014; 13. 2014/05/16. DOI: 10.2310/7290.2014.00015.
  • 16. De Wever W, Bruyeer E, Demaerel P, et al. Staging of lung cancer. Do we need a diagnostic CT of the brain after an integrated PET/CT for the detection of brain metastases? Jbr-btr 2010; 93(2): 71-6. 2010/06/09. doi: 10.5334/jbr-btr.122.

The Appearances of Brain Metastases of Small Cell Lung Cancer on 18F-FDG PET/CT

Year 2022, Volume: 32 Issue: 3, 272 - 275, 01.08.2022
https://doi.org/10.54005/geneltip.1073349

Abstract

Purpose: We evaluate the appearances of the brain metastases (BMs) detected by brain magnetic resonance imaging (MRI) of small cell lung cancer (SCLC) on 18Fluor-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).
Patients and methods: SCLC patients who had an 18F-FDG PET/CT scan and a brain MRI within 30 days for initial staging were included. MRI was used to detect BMs. The imaging results of BMs on 18F-FDG PET/CT were assessed. On the 18F-FDG PET/CT study, the BMs were classified as undetectable, hypometabolic, hypermetabolic, or mixed patterns (lesions with both hypermetabolic and hypometabolic parts).
Results: A total of 51 patients [48 (94.1%) of whom were male and 3 (5.9%) female, with an average age of 62.57 ± 9.64] were included in this study. Fifteen patients (29.4%) were in the limited stage, whereas 36 patients (69.6%) were in the extensive stage. In 11 individuals, MRI indicated 28 BMs. On 18F-FDG PET/CT, 13 of the 28 metastases were visible. The following were the BMs appearances on 18F-FDG PET/CT: hypometabolic (n: 4), hypermetabolic (n: 6), and mixed (n: 3). While the mean diameter of BMs detected in 18F-FDG PET/CT was 16mm; the mean diameter of undetected ones was 4.3 mm.
Conclusion: On 18F-FDG PET/CT, BMs can have a variety of appearances, including hypometabolic, hypermetabolic, and mixed patterns. On the other hand, failure to detect millimetric size BMs in 18F-FDG PET/CT prevents proper staging.

References

  • 1. Ko J, Winslow MM, Sage J. Mechanisms of small cell lung cancer metastasis. EMBO Mol Med 2021; 13(1): e13122. 2020/12/10. doi: 10.15252/emmm.202013122.
  • 2. Rittberg R, Banerji S, Kim JO, Rathod S, Dawe DE. Treatment and Prevention of Brain Metastases in Small Cell Lung Cancer. Am J Clin Oncol 2021; 44(12): 629-38. 2021/10/11. doi: 10.1097/coc.0000000000000867.
  • 3. Hochstenbag MM, Twijnstra A, Wilmink JT, Wouters EF, ten Velde GP. Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC): MR-imaging is useful at initial diagnosis. J Neurooncol 2000; 48(3): 243-8. 2000/12/02. doi: 10.1023/a:1006427407281.
  • 4. Lu YY, Chen JH, Liang JA et al. 18F-FDG PET or PET/CT for detecting extensive disease in small-cell lung cancer: a systematic review and meta-analysis. Nucl Med Commun 2014; 35(7): 697-703. 2014/04/04. doi: 10.1097/mnm.0000000000000122.
  • 5. Vinjamuri M, Craig M, Campbell-Fontaine A, et al. Can positron emission tomography be used as a staging tool for small-cell lung cancer? Clin Lung Cancer 2008; 9(1): 30-4. 2008/02/20. doi: 10.3816/CLC.2008.n.005.
  • 6. Palomar Muñoz A, García Vicente AM, Bellón Guardia ME, et al. Is a selective brain (18)F-FDG PET/CT study profitable in patients with small cell lung cancer? Rev Esp Med Nucl Imagen Mol 2012; 31(3): 124-9. 2011/07/05. doi: 10.1016/j.remn.2011.05.002.
  • 7. Omuro AM, Leite CC, Mokhtari K, Delattre JY. Pitfalls in the diagnosis of brain tumours. Lancet Neurol 2006; 5(11): 937-48. 2006/10/21. doi: 10.1016/s1474-4422(06)70597-x.
  • 8. Lee HY, Chung JK, Jeong JM, et al. Comparison of FDG-PET findings of brain metastasis from non-small-cell lung cancer and small-cell lung cancer. Ann Nucl Med 2008; 22(4): 281-6. 2008/06/07. doi: 10.1007/s12149-007-0104-1.
  • 9. Stahel RA, Ginsberg R, Havemann K, et al. Staging and prognostic factors in small cell lung cancer: a consensus report. Lung cancer 1989; 5(4-6): 119-26.
  • 10. Brink I, Schumacher T, Mix M, et al. Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer. Eur J Nucl Med Mol Imaging 2004; 31(12): 1614-20. 2004/07/20. doi: 10.1007/s00259-004-1606-x.
  • 11. Hjorthaug K, Højbjerg JA, Knap MM, et al. Accuracy of 18F-FDG PET-CT in triaging lung cancer patients with suspected brain metastases for MRI. Nucl Med Commun 2015; 36(11): 1084-90. 2015/08/25. doi: 10.1097/mnm.0000000000000371.
  • 12. Zimmer L, Luxen A. PET radiotracers for molecular imaging in the brain: past, present and future. Neuroimage 2012; 61(2): 363-70. 2012/01/10. doi: 10.1016/j.neuroimage.2011.12.037.
  • 13. Fink KR, Fink JR. Imaging of brain metastases. Surg Neurol Int 2013; 4(Suppl 4): S209-19. 2013/05/30. doi: 10.4103/2152-7806.111298.
  • 14. Kitajima K, Nakamoto Y, Okizuka H, et al. Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors. Ann Nucl Med 2008; 22(7): 595-602. 2008/08/30. doi: 10.1007/s12149-008-0145-0.
  • 15. Juhász C, Dwivedi S, Kamson DO, Michelhaugh SK, Mittal S. Comparison of amino acid positron emission tomographic radiotracers for molecular imaging of primary and metastatic brain tumors. Mol Imaging 2014; 13. 2014/05/16. DOI: 10.2310/7290.2014.00015.
  • 16. De Wever W, Bruyeer E, Demaerel P, et al. Staging of lung cancer. Do we need a diagnostic CT of the brain after an integrated PET/CT for the detection of brain metastases? Jbr-btr 2010; 93(2): 71-6. 2010/06/09. doi: 10.5334/jbr-btr.122.
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Article
Authors

Hasan Önner 0000-0003-1002-2097

Farise Yılmaz 0000-0001-8136-513X

Halil Özer 0000-0003-1141-1094

Abdussamet Batur 0000-0003-2865-9379

Gonca Kara Gedik This is me 0000-0003-4607-8615

Publication Date August 1, 2022
Submission Date February 14, 2022
Published in Issue Year 2022 Volume: 32 Issue: 3

Cite

Vancouver Önner H, Yılmaz F, Özer H, Batur A, Kara Gedik G. The Appearances of Brain Metastases of Small Cell Lung Cancer on 18F-FDG PET/CT. Genel Tıp Derg. 2022;32(3):272-5.

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