18F-FDG PET/CT for detection of the primary tumor in adults with extracervical metastases from cancer of unknown primary

Burglin, Synne Alexandra; Hess, Søren; Høilund‐Carlsen, Poul Flemming; Gerke, Oke

doi:10.1097/md.0000000000006713

Cited by 61 publications

(45 citation statements)

References 29 publications

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“…[ 18 F]-2 deoxyglucose ( 18 F-FDG) is a conventional clinical PET imaging agent, which is mainly based on the higher metabolism and more uptake of glucose of tumor tissues than normal tissues. 17,18 However, as a nonspecific tumor imaging agent, 18 F-FDG is highly biased for early diagnosis of lung cancer because of the slow growth and reduced glucose metabolism of early lung cancer. 19 In addition, inflammatory sites can also accumulate high concentrations of 18 F-FDG imaging agent, resulting in misdiagnosis of clinical lung cancer.…”

Section: ■ Introductionmentioning

confidence: 99%

Inherently PET/CT Dual Modality Imaging Lipid Nanocapsules for Early Detection of Orthotopic Lung Tumors

Cai

Yang

et al. 2019

ACS Appl. Bio Mater.

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Accurate diagnosis of cancer at an early stage is the key to reduce cancer mortality and improve survival. PET imaging has high sensitivity but low spatial resolution, while CT imaging has good spatial location information. Therefore, the combination of PET and CT imaging can provide complementary advantages to achieve accurate early diagnosis of tumors. However, currently developed PET or CT imaging agents have only a single function. Here, we designed and constructed a selfassembled lipid nanocapsule encapsulated with iodixanol and labeled with self-chelated 64 Cu for precise PET/CT imaging of tiny lung tumor. The lipid nanocapsule self-assembled in water using LPPC-Ce6, a conjugate of chlorin e6 (Ce6) and lysophosphatidylcholine (LPPC), to form a bilayer vesicular structure. 64 Cu was embedded in the center of the tetrapyrrole ring of Ce6 by natural capture ability for Cu 2+ ions. GLT21.T, the aptamer targeting lung cancer, was conjugated to the surface of the lipid nanocapsules. Iodixanol was loaded into the cavity of the lipid nanocapsule (64 Cu@LCI-apt). In the nanostructure, the loading of iodixanol was sufficiently high, and the specific activity could be flexibly adjusted according to imaging requirements. The prepared 64 Cu@LCI-apt achieves excellent radiolabeling efficiency, stability and effective targeting of lung tumor. In an early orthotopic lung cancer model, 64 Cu@LCI-apt demonstrated the capabilities of sensitive PET imaging and enhanced contrast CT imaging to enable efficient high-quality PTE/CT imaging of tiny orthotopic lung tumor with a diameter of 500 μm. 64 Cu@LCI-apt has great potential for early, sensitive, and accurate diagnosis of tumors through dual-mode PET/CT imaging.

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Section: ■ Introductionmentioning

confidence: 99%

Inherently PET/CT Dual Modality Imaging Lipid Nanocapsules for Early Detection of Orthotopic Lung Tumors

Cai

Yang

et al. 2019

ACS Appl. Bio Mater.

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“…CT scans of thorax, abdomen and pelvis constitute a minimal basic workup . PET/CT scan has rapidly become the new standard imaging in the abdomen/pelvis and is characterized by high detection rate of a primary tumour in CUP but the guidelines limit its role to cervical CUP and single CUP metastasis . The role of PET/CT scan should be reconsidered in prospective studies in view of its positive input in anogenital tumours .…”

Section: Discussionmentioning

confidence: 99%

“…1 PET/CT scan has rapidly become the new standard imaging in the abdomen/pelvis and is characterized by high detection rate of a primary tumour in CUP but the guidelines limit its role to cervical CUP and single CUP metastasis. 1,25,26 The role of PET/CT scan should be reconsidered in prospective studies in view of its positive input in anogenital tumours. 27,28 Nevertheless, its effectiveness may be limited by the low metastatic potential of this CUP subset as only 12.5% of patients presented distant metastasis.…”

Section: Perspectivementioning

confidence: 99%

A new entity of abdominal squamous cell carcinoma of unknown primary

Rassy

Kattan

Pavlidis

2019

Eur J Clin Investigation

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“…[ 3 ] Previous literature has shown that the role of FDG-PET is limited, with a primary lesion detection rate of approximately 40% in patients with CUP. [ 4 ] Examinations of biopsy specimens are mandatory, and immunohistochemistry is the gold standard for diagnosing CUP. [ 5 ] Keratin expression patterns of the biopsy specimen of this patient were consistent with the diagnosis of epithelial tumor, such as lung adenocarcinoma, breast ductal carcinoma, ovarian serous papillary carcinoma, and endometrial adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Mandibular metastasis as the first clinical indication of occult lung adenocarcinoma with multiple metastases

et al. 2018

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Rationale:Although metastases to the oral and maxillofacial region (OMR) are rare, the lung is the most common primary site metastasizing to the OMR.Patient concerns:An 83-year-old woman presented with reports of trismus, occlusal discomfort, swelling, and spontaneous pain in the right buccal region. Despite the absence of abnormal chest imaging findings, immunohistochemical analysis of biopsy specimens of the mandible and the thyroid indicated that the patient had multiple metastases from a lung poorly differentiated adenocarcinoma.Diagnoses:Metastases to the OMR and the thyroid from an undiscovered lung adenocarcinoma.Interventions:Gefitinib was started as first-line chemotherapy, and zoledronic acid was administered for bone metastases.Outcomes:Follow-up imaging examinations showed ossification and deformation of the right mandibular ramus and the condylar process. Although 2 years have passed since the first visit to our hospital, lung lesions have not been confirmed by imaging examinations.Lessons:Clinicians should consider the possibility that symptoms in the OMR may be the first clinical sign of an undiscovered distant primary tumor, and the primary tumors may not be detected by imaging examinations even when metastases to the OMR are revealed.

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18F-FDG PET/CT for detection of the primary tumor in adults with extracervical metastases from cancer of unknown primary

Abstract: Supplemental Digital Content is available in the text

Cited by 61 publications

References 29 publications

Inherently PET/CT Dual Modality Imaging Lipid Nanocapsules for Early Detection of Orthotopic Lung Tumors

Inherently PET/CT Dual Modality Imaging Lipid Nanocapsules for Early Detection of Orthotopic Lung Tumors

A new entity of abdominal squamous cell carcinoma of unknown primary

Mandibular metastasis as the first clinical indication of occult lung adenocarcinoma with multiple metastases

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