OBJECTIVES: The clinical utility of fluorodeoxyglucose-positron emission tomography (FDG-PET) and somatostatin receptor scintigraphy (SRS) in pulmonary carcinoids staging is unclear. This study aims to determine the role of FDG-PET and SRS in detecting hilar-mediastinal lymph node metastasis from these tumours. METHODS: We retrospectively collected the data of 380 patients who underwent lung resection for primary pulmonary carcinoid in seven centres between 2000 and 2015. Patients without nodal sampling (n = 78) were excluded. In 302 patients [35% men, median age 58 (interquartile range 47-68) years] the results of preoperative computed tomography (CT) scan, FDG-PET and SRS were analysed and compared to the pathological findings after resection to determine the respective utility of these two nuclear tests. RESULTS: The sensitivity, specificity and negative predictive value in detecting N1 and N2 disease were respectively 33% and 46%, 93% and 90%, 88% and 95% for computed-tomography-scan, 38% and 60%, 93% and 95%, 88% and 95% for FDG-PET, 22% and 33%, 95% and 98%, 84% and 87% for SRS. The diagnostic accuracy for N1 and N2 disease of CT scan was not significantly different from that of FDG-PET (P = 1.0 and P = 0.37 for N1 and N2 disease respectively) and of SRS (P = 0.47 and P = 0.35 for N1 and N2 disease respectively). The sensitivity and specificity of these imaging tests were also similar when analysed by typical vs atypical histology. CONCLUSIONS: CT scan, FDG-PET and SRS showed similar performance in terms of nodal staging for pulmonary carcinoid. These findings suggest that additional nuclear imaging beyond CT scan is not required as long as a lymphadenectomy or nodal sampling is completed at resection.

Is there a role for traditional nuclear medicine imaging in the management of pulmonary carcinoid tumours? / Cattoni, M.; Vallieres, E.; Brown, L. M.; Sarkeshik, A. A.; Margaritora, S.; Siciliani, A.; Imperatori, A.; Rotolo, N.; Farjah, F.; Wandell, G.; Costas, K.; Mann, C.; Hubka, M.; Kaplan, S.; Farivar, A. S.; Aye, R. W.; Louie, B. E.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 51:5(2017), pp. 874-879. [10.1093/ejcts/ezw422]

Is there a role for traditional nuclear medicine imaging in the management of pulmonary carcinoid tumours?

Siciliani A.;
2017

Abstract

OBJECTIVES: The clinical utility of fluorodeoxyglucose-positron emission tomography (FDG-PET) and somatostatin receptor scintigraphy (SRS) in pulmonary carcinoids staging is unclear. This study aims to determine the role of FDG-PET and SRS in detecting hilar-mediastinal lymph node metastasis from these tumours. METHODS: We retrospectively collected the data of 380 patients who underwent lung resection for primary pulmonary carcinoid in seven centres between 2000 and 2015. Patients without nodal sampling (n = 78) were excluded. In 302 patients [35% men, median age 58 (interquartile range 47-68) years] the results of preoperative computed tomography (CT) scan, FDG-PET and SRS were analysed and compared to the pathological findings after resection to determine the respective utility of these two nuclear tests. RESULTS: The sensitivity, specificity and negative predictive value in detecting N1 and N2 disease were respectively 33% and 46%, 93% and 90%, 88% and 95% for computed-tomography-scan, 38% and 60%, 93% and 95%, 88% and 95% for FDG-PET, 22% and 33%, 95% and 98%, 84% and 87% for SRS. The diagnostic accuracy for N1 and N2 disease of CT scan was not significantly different from that of FDG-PET (P = 1.0 and P = 0.37 for N1 and N2 disease respectively) and of SRS (P = 0.47 and P = 0.35 for N1 and N2 disease respectively). The sensitivity and specificity of these imaging tests were also similar when analysed by typical vs atypical histology. CONCLUSIONS: CT scan, FDG-PET and SRS showed similar performance in terms of nodal staging for pulmonary carcinoid. These findings suggest that additional nuclear imaging beyond CT scan is not required as long as a lymphadenectomy or nodal sampling is completed at resection.
2017
Computed tomography scan; Fluorodeoxyglucose positron emission tomography; Mediastinal staging; Pulmonary carcinoid tumours; Somatostatin receptor scintigraphy; Aged; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Neoplasm Staging; Retrospective Studies; Carcinoid Tumor; Lung Neoplasms; Positron-Emission Tomography; Radionuclide Imaging; Tomography, X-Ray Computed
01 Pubblicazione su rivista::01a Articolo in rivista
Is there a role for traditional nuclear medicine imaging in the management of pulmonary carcinoid tumours? / Cattoni, M.; Vallieres, E.; Brown, L. M.; Sarkeshik, A. A.; Margaritora, S.; Siciliani, A.; Imperatori, A.; Rotolo, N.; Farjah, F.; Wandell, G.; Costas, K.; Mann, C.; Hubka, M.; Kaplan, S.; Farivar, A. S.; Aye, R. W.; Louie, B. E.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 51:5(2017), pp. 874-879. [10.1093/ejcts/ezw422]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1521238
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