The role of positron emission tomography with
<sup>18</sup>
F-fluoro-2-deoxy-D-glucose in respiratory oncology

Vansteenkiste, Johan; Stroobants, Sigrid

doi:10.1183/09031936.01.17408020

Cited by 98 publications

(31 citation statements)

References 156 publications

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“…FDG-PET proved to be significantly more accurate than CT in locoregional LN staging. In the distinction between presence (N2-N3) or absence (N0-N1) of mediastinal LN disease, an overall sensitivity of 89% (67-100), a specificity of 92% and an accuracy of 90% (78-100) can be expected for FDG-PET, in contrast with a sensitivity of 65% , a specificity of 80% , and an accuracy of 75% (52-79) for CT [21]. The superiority of FDG-PET can be explained by the fact that the size of LNs on CT is a relative criterion; FDG-PET correctly identifies small malignant nodes and large benign nodes.…”

Section: Locoregional Lymph Node Stagingmentioning

confidence: 97%

“…Based on 12 well-designed prospective studies, it can be concluded that FDG-PET has proven to be accurate in differentiating benign from malignant lesions as small as 1 cm [21]. An overall sensitivity of 96% (range 83-100), specificity of 79% (52-100) and accuracy of 91% (86-100) can be expected.…”

Section: Diagnosis Of Solitary Lung Nodule or Massmentioning

confidence: 99%

“…A summary of the possible clinical implementation that was suggested by VANSTEENKISTE and STROOBANTS [21] in a recent review is depicted in figure 3 Other indications, such as evaluation of radioor chemotherapy, radiotherapy planning, recurrence detection and prognosis determination also need further well-designed prospective investigations, but in more specialized centres.…”

Section: Conclusion and Prospectsmentioning

confidence: 99%

“…The standard clinical indications for FDG-PET imaging in lung cancer patients have been detailed in a recent review [21]. In this contribution, these indications will only be repeated briefly, with emphasis on clinical application.…”

Section: Common Clinical Indicationsmentioning

confidence: 99%

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Imaging in lung cancer: positron emission tomography scan

Vansteenkiste¹

2002

Eur Respir J

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In the past 5 yrs, positron emission tomography (PET), usually used with 18 F-fluoro-2-deoxy-glucose (FDG), has become an important imaging modality in lung cancer patients.Currently, the use of FDG-PET in respiratory oncology is mainly for diagnosis and staging. Standard indications are the evaluation of an indeterminate solitary pulmonary nodule or mass, where FDG-PET has proven to be significantly more accurate than computed tomography (CT) in the distinction between benign and malignant lesions. Several studies have also convincingly demonstrated that locoregional lymph node staging by FDG-PET (in correlation with CT images) is significantly superior to CT, with a negative predictive value equal or even superior to mediastinoscopy. FDG-PET also improves extrathoracic staging, through the detection of lesions missed at conventional imaging or characterization of lesions that remain equivocal on conventional imaging. Many European countries now have or plan reimbursement in these indications. Large-scale randomized studies should now focus on the impact this accurate tumour imaging technique has on treatment outcome and cost-efficacy.Ongoing studies in specialized centres focus on the use of FDG-PET in more advanced clinical applications, such as planning radiotherapy, response evaluation after radiotherapy or (induction) chemotherapy, follow-up and early detection of recurrence, and prognostic information in this in vivo measurement of tumour glucose metabolism.After a short note on the technique used and a summary of the current common indications of diagnosis and staging, this paper will deal mainly with two of the more advanced clinical applications of FDG-PET in locally advanced nonsmall cell lung cancer: radiation treatment planning and assessment of induction chemotherapy.Finally, it should be mentioned that a whole new field of applications of positron emission tomography in molecular biology, using new radiopharmaceutical probes, is under extensive investigation. These techniques are promising for future use in very early response monitoring during chemo-or radiotherapy, in evaluation of novel molecular-targeted lung cancer therapies, or even gene therapy.

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Section: Locoregional Lymph Node Stagingmentioning

confidence: 97%

Section: Diagnosis Of Solitary Lung Nodule or Massmentioning

confidence: 99%

Section: Conclusion and Prospectsmentioning

confidence: 99%

Section: Common Clinical Indicationsmentioning

confidence: 99%

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Imaging in lung cancer: positron emission tomography scan

Vansteenkiste¹

2002

Eur Respir J

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“…In recent months the European Respiratory Journal has published a series of articles on advances in imaging [1][2][3][4][5][6][7][8]. These articles have reviewed the current role of imaging in the diagnosis and management of various airway and pulmonary diseases and have highlighted potential areas of research.…”

mentioning

confidence: 99%

Advances in imaging

Müller¹

2001

European Respiratory Journal

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In recent years there have been major advances in chest imaging. These include significant refinements in previously available techniques such as computed tomography (CT) and magnetic resonance (MR) imaging and the introduction of new techniques into the clinical armamentarium, particularly positron emission tomography (PET) imaging.These advances have led to changes in the diagnostic approach to a number of conditions, particularly pulmonary embolism, lung cancer, diseases of the large and small airways, and diffuse lung disease. They have also brought new insights into the pathophysiology of lung disease.State of the art CT and MR imaging now allow objective quantification of lung disease and assessment of regional changes in ventilation and perfusion caused by airway and parenchymal abnormalities.The aim of this article is to summarize the most important clinical applications of the recent advances in imaging and to emphasize the topics of imaging research likely to attract particular attention from radiologists and clinicians in the near future. In recent months the European Respiratory Journal has published a series of articles on advances in imaging [1][2][3][4][5][6][7][8]. These articles have reviewed the current role of imaging in the diagnosis and management of various airway and pulmonary diseases and have highlighted potential areas of research. The present article will only consider what the author deems to be the most important clinical applications and the most pressing topics of imaging research. The article will focus on imaging in pulmonary embolism, lung cancer, airway diseases, and parenchymal lung disease. The discussion will be based on recent advances in computed tomography (CT) and magnetic resonance (MR) technology and the introduction of positron emission tomography (PET) imaging.The main developments of CT in the chest have been the introduction of high-resolution CT (HRCT), spiral CT and, more recently, multislice CT.HRCT is defined as thin-section CT (1-2-mm collimation scans) optimized by using a high spatialresolution (edge enhancing) algorithm. Several studies have shown that HRCT closely reflects the macroscopic (gross) pathological findings. HRCT presently has the best sensitivity and specificity of any imaging method for the assessment of focal and diffuse lung diseases. Spiral (helical) CT provides continuous scanning while the patient is being moved continuously through the CT gantry. It allows true volumetric scanning of the entire lung during a single breath hold and has replaced the slice-by-slice acquisition of conventional CT. Spiral CT permits for reconstruction of images in any plane as well as three-dimensional (3D) display of structures. With the use of graphics based software programs, spiral CT allows depiction of the luminal surface of the airways with images that resemble those of bronchoscopy (CT bronchoscopy) or bronchography (CT bronchography). The combination of spiral CT with administration of intravenous contrast (CT angiography) allows visualizat...

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