Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer? Kemp H Kernstine, MD, PhD, Kelley A McLaughlin,

Slides:

Advertisements

Similar presentations

NeoTect Tc99m Depreotide Injection. NeoTect  Approved by the FDA - August 3, 1999  Used in Imaging Pulmonary Masses  Normal activity in high concentrations.

Advertisements

CT and PET imaging in non-small cell lung cancer

MRI as an Alternative to CT-Guided Biopsy of Adrenal Masses in Patients With Lung Cancer Lawrence H Schwartz, Michelle S Ginsberg, Michael E Burt, Karen.

Endoscopic Ultrasound-Guided Fine Needle Aspiration of Mediastinal Lymph Node in Patients With Suspected Lung Cancer After Positron Emission Tomography.

Jeffrey L. Port, MD, Robert J. Korst, MD, Paul C. Lee, MD, Amanda L

PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma Kemp H Kernstine, MD, PhD, William Stanford, MD, Brian F Mullan,

FDG PET-CT Aids in the Preoperative Assessment of Patients with Newly Diagnosed Thymic Epithelial Malignancies Marcelo F.K. Benveniste, MD, Cesar A.

Tc99m Depreotide Injection

PET/CT Fusion Scan in Lung Cancer: Current Recommendations and Innovations Cristina Gámez, MD, PhD, Rafael Rosell, MD, PhD, Alejandro Fernández, MD, PhD,

Mediastinal lymph node staging of non-small-cell lung cancer: A prospective comparison of computed tomography and positron emission tomography Walter.

Positron Emission Tomography in Lung Cancer

Diffusion-weighted magnetic resonance imaging in preoperative assessment of non– small cell lung cancer Hiroaki Nomori, MD, Yue Cong, MD, Masaru Abe,

Paraneoplastic Opsoclonus-Myoclonus Syndrome as a New and Single Manifestation of Relapsing Disease in a Patient with Small Cell Lung Cancer Ernest Nadal,

Endobronchial ultrasonography (EBUS)—Its role in staging of non–small cell lung cancer and who should do it? Rafael S. Andrade, MD, David D. Odell, MD,

Standard Uptake Value Predicts Survival in Non–Small Cell Lung Cancer

Does the method of radiologic surveillance affect survival after resection of stage I non– small cell lung cancer? Traves D. Crabtree, MD, Varun Puri,

Thoracoscopic and laparoscopic lymph node staging in esophageal cancer: do clinicopathological factors affect the outcome? Mark J Krasna, MD, Xiaolong.

Sarcoid-Like Reaction Mimics Progression of Disease After Induction Chemotherapy for Lung Cancer Masayuki Chida, MD, PhD, Takashi Inoue, MD, Koichi Honma,

Resection of Mucinous Lung Adenocarcinoma Presenting with Intractable Bronchorrhea Motoshi Takao, MD, PhD, Takehiro Takagi, MD, Hitoshi Suzuki, MD, PhD,

Salvage Lung Resection After Definitive Radiation (>59 Gy) for Non-Small Cell Lung Cancer: Surgical and Oncologic Outcomes Julie E. Bauman, MD, Michael.

Unexpected Small Bowel Intussusception Caused by Lung Cancer Metastasis on 18F- Fluorodeoxyglucose PET-CT Jeong Won Lee, MD, Seok-Ki Kim, MD, Ji Won Park,

The True False Negative Rates of Esophageal and Endobronchial Ultrasound in the Staging of Mediastinal Lymph Nodes in Patients With Non-Small Cell Lung.

Misdiagnosis of a Small Cell Lung Cancer Resulting From Inaccurate Pathology Tie-niu Song, MD, Jian-hua Zhang, MD, PhD, Bin Li, PhD, Hui Zhou, BA, Peng.

Meta-Analysis of Positron Emission Tomographic and Computed Tomographic Imaging in Detecting Mediastinal Lymph Node Metastases in Nonsmall Cell Lung Cancer

Rapid Response of Brain Metastasis to Crizotinib in a Patient with ALK Rearrangement– Positive Non–Small-Cell Lung Cancer Hiroyasu Kaneda, MD, PhD, Isamu.

Positron emission tomographic imaging with fluorodeoxyglucose is efficacious in evaluating malignant pulmonary disease Geoffrey M. Graeber, MD*, Naresh.

Ali Shahriari, MD, John A Odell The Annals of Thoracic Surgery

Cost-Effectiveness of Initial Diagnostic Strategies for Pulmonary Nodules Presenting to Thoracic Surgeons Stephen A. Deppen, MA, MS, William T. Davis,

Surgical treatment of metachronous second primary lung cancer after complete resection of non–small cell lung cancer Masatsugu Hamaji, MD, Mark S. Allen,

Makio Hayama, MD, Hiroya Maeda, MD The Annals of Thoracic Surgery

Surgical treatment of non-small cell lung cancer 1 cm or less in diameter Daniel L Miller, MD, Charles M Rowland, MS, Claude Deschamps, MD, Mark S Allen,

Thyroid Cancer With a Cystic Mediastinal Tumor Invading the Right Main Bronchus Ryuichi Suemitsu, MD, PhD, Sadanori Takeo, MD, PhD, Motoharu Hamatake,

Mediastinal Lymph Node Examination and Survival in Resected Early-Stage Non– Small-Cell Lung Cancer in the Surveillance, Epidemiology, and End Results.

Utility of Routine PET Imaging to Predict Response and Survival After Induction Therapy for Non-Small Cell Lung Cancer Stephen A. Barnett, MBBS, Robert.

Salvage Operation in Case of Oligometastatic Disease

Thymic and Mediastinal Lymph Node Metastasis of Colon Cancer

MRI as an Alternative to CT-Guided Biopsy of Adrenal Masses in Patients With Lung Cancer Lawrence H Schwartz, Michelle S Ginsberg, Michael E Burt, Karen.

Number of Lymph Nodes Associated With Maximal Reduction of Long-Term Mortality Risk in Pathologic Node-Negative Non–Small Cell Lung Cancer Raymond U.

Christopher K. Mehta, MD, Colin T

The role of positron emission tomography for non-small cell lung cancer Albert J. Chang, MD, PhD, Farrokh Dehdashti, MD, Jeffrey D. Bradley, MD Practical.

Differences in Patterns of Recurrence in Early-Stage Versus Locally Advanced Non- Small Cell Lung Cancer Feiran Lou, MD, MS, Camelia S. Sima, MD, MS,

Elderly Former Smoker with HRAS Mutant Non–Small-Cell Lung Cancer

A Patient With BRAF V600E Lung Adenocarcinoma Responding to Vemurafenib Oliver Gautschi, MD, Chantal Pauli, MD, Klaus Strobel, MD, Astrid Hirschmann,

Positron Emission Tomography 18F-Fluorodeoxyglucose Uptake and Prognosis in Patients with Surgically Treated, Stage I Non-small Cell Lung Cancer: A Systematic.

Pulmonary Metastases from Cervical Adenocarcinoma Regress to a ‘Hole’ Lot of Nothing Michael Guandalini, MBBS (Hons), BPhty, Karin Steinke, MD, MS, PD,

Matthew Reichert, MD, Eric S. Bensadoun, MD

Are discordant positron emission tomography and pathological assessments of the mediastinum in non–small cell lung cancer significant? Daniel J. Tandberg,

Nicholas W. Choong, MD, Robert S. Hellman, MD

A novel technique for localization and excisional biopsy of small or Ill-defined pulmonary lesions Thomas M Daniel, MD, Talissa A Altes, MD, Patrice.

Marianna Koczywas, MD, Mihaela C. Cristea, MD

Primary desmoid tumor of the posterior mediastinum

Metastatic Lung Cancer to the Pancreas

Evaluation of fluorine-18-fluorodeoxyglucose whole body positron emission tomography imaging in the staging of lung cancer Catherine A.B Saunders, Julian.

Qing-yu Wu, MD The Annals of Thoracic Surgery

Cardiac pheochromocytoma: resection after diagnosis by 111-indium octreotide scan Jeffrey C Lin, MD, Brian A Palafox, MD, Hollie A Jackson, MD, Allen.

Endotracheal and Endobronchial Metastases in a Patient With Stage I Lung Adenocarcinoma Zhirong Zhang, MD, Yousheng Mao, MD, Huang Chen, MD, Jingsi Dong,

Sequential Mediastinal Lymphadenectomy of an Unknown Primary Tumor

CT (left of images) showing calcified areas and PET (right of images) scans showing increased FDG-PET metabolic activity in the mediastinal mass (A) and.

Walter J. Scott, MD, James Shepherd, MS, Sanjiv Sam Gambhir, MD, PhD

Primary Pleural Malignant Melanoma With Rapid Progression

FDG imaging of a pulmonary artery sarcoma

Surgical resection of a solitary plasmacytoma originating in a rib of a patient with Castleman’s disease Simon Wilkinson, MRCS, Christopher P Forrester-Wood,

Mark I. Block, MD The Annals of Thoracic Surgery

Lack of FDG Uptake in Small Cell Carcinoma Associated with ANNA-1 Positive Paraneoplastic Autonomic Neuropathy Matthew S. Block, MD, PhD, Robert Vassallo,

Resection of primary brachial plexus tumor using a modified Dartevelle anterior approach Andrew Morton, Mark J Krasna, MD, Charles S White, MD, Joseph.

Mediastinal parathyroid cysts revisited

Evaluation of lymph node metastases in squamous cell carcinoma of the esophagus with positron emission tomography Kwhanmien Kim, MD, Seung Joon Park,

Meghan R. Flanagan, MD, Thomas K. Varghese, MD, MS, Leah M

Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography Michael B Wallace, MD, James Ravenel, MD, Mark I Block,

Survival of Patients With Unsuspected pN2 Non-Small Cell Lung Cancer After an Accurate Preoperative Mediastinal Staging Carme Obiols, MD, Sergi Call,

Presentation transcript:

Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer? Kemp H Kernstine, MD, PhD, Kelley A McLaughlin, RN, Yusuf Menda, MD, Nicholas P Rossi, MD, Daniel J Kahn, MD, David L Bushnell, MD, Michael M Graham, MD, PhD, Carl K Brown, MS, Mark T Madsen, PhD The Annals of Thoracic Surgery Volume 73, Issue 2, Pages 394-402 (February 2002) DOI: 10.1016/S0003-4975(01)03432-4

Fig 1 (A) Computed tomogram and (B) positron emission tomogram (PET) with suspicious parenchymal mass on computed tomographic scan (CT) and PET negative and no PET mediastinal disease. A transverse image of a CT scan and a coronal image of a PET scan in the same patient with a suspicious lung mass. The standard uptake value (SUV) of the 1.5 cm spiculated noncalcified mass (arrow) was zero. There was no fluorodeoxyglucose uptake in the mediastinum. Biopsy of the mediastinal lymph nodes was negative for malignancy. The primary was an adenocarcinoma. From our data and analysis, in patients such as this individual, in which the SUV of the primary lesion is less than 2.5 and the mediastinum is PET negative, mediastinoscopy is unnecessary. The Annals of Thoracic Surgery 2002 73, 394-402DOI: (10.1016/S0003-4975(01)03432-4)

Fig 2 Potential algorithm coordinating the use of positron emission tomography (PET) in the evaluation of patients with non-small cell lung cancer (NSCLC). Performance of tests, inclusive of pulmonary function tests (PFTs), bronchoscopy, bone scan, head computed tomography or magnetic resonance imaging, evaluation of combined diseases or performance status, may be performed at the discretion of the examiner or dependent upon the initial evaluation of the patient. Operable patients with known group or suspect group NSCLC should have a PET scan in addition to the chest computed tomographic scan. Ten percent to 20% (A) will be found to have asymptomatic unrecognized metastases of which half, 5% to 10% (C), will be found to be positive by minimal invasive testing that will warrant no pulmonary surgical resection [10]. The other 10% (D) will need further thoracic surgical evaluation. From this report, an additional 12% (B) will be found not to need mediastinoscopy. Combining (C) and (B), by using PET, it appears that mediastinoscopy will be unnecessary in 15% to 20% of patients. The Annals of Thoracic Surgery 2002 73, 394-402DOI: (10.1016/S0003-4975(01)03432-4)