Malignant tumor; Diseases of the osteoarticular system; Radionuclide study; Bronchus disease; Lung disease; Respiratory disease; Glucose; Radiolabelling; Fluorite; Positron; Emission tomography; Sensitivity; Evaluation; Diagnosis; Bone; Metastasis; Non small cell carcinoma; Human; Bronchopulmonary; Tumeur maligne; Exploration radioisotopique; Système ostéoarticulaire pathologie; Bronche pathologie; Poumon pathologie; Appareil respiratoire pathologie; Marquage radioisotopique; Fluorine; Positon; Tomoscintigraphie; Sensibilité; Diagnostic; Os; Métastase; Carcinome non petite cellule; Homme; Bronchopulmonaire
Abstract :
[en] Despite advances in morphological imaging, some patients with lung cancer are found to have non resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. We have attempted to evaluate the utility of the fluorine-18 deoxyglucose positron emission tomography (FDG PET) for the detection of bone metastasis. One hundred and ten consecutive patients with histological diagnosis of non-small cell lung cancer (NSCLC) who underwent both FDG PET and bone scintigraphy were selected for this review. In this group, there were 43 patients with metastatic disease (stage IV). Among these. 21 (19% of total group) had one or several bone metastases confirmed by biopsy (n = 8) or radiographic techniques (n = 13). Radionuclide bone scanning correctly identified 54 out of 89 cases without osseous involvement and 19 out of 21 osseous involvements. On the other hand, FDG PET correctly identified the absence of osseous involvement in 87 out of 89 patients and the presence of bone metastasis in 19 out of 21 patients. Thus using PET there were two false-negative and two false-positive cases. PET and bone scanning had, respectively, an accuracy of 96% and 66% in the evaluation of osseous involvement in patients with NSCLC. In conclusion, our data suggest that whole-body FDG PET may be useful in detecting bone metastases in patients with known NSCLC.
Disciplines :
Oncology
Author, co-author :
Bury, Thierry ; Université de Liège - ULiège > Département des sciences de la motricité > Physiologie humaine et physiologie de l'effort physique
BARRETO, A.; Centre Hospitalier Universitaire de Liège - CHU > Nuclear Medicine
Daenen, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Nuclear Medicine
BARTHELEMY, Nicole ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Standord W, Spivey C, Larsen G et al. Results of treatment of primary carcinoma of the lung: analysis of 3000 cases. J Thorac Cardiovasc Surg 1976; 72: 441.
Nolop K, Rhodes C, Brudin L, Beanay R, Krausz T, Jones T, Hughes J. Glucose utilization in vivo by human pulmonary neoplasms. Cancer 1987; 60: 2682-2689.
Rege S, Hoh C, Glaspy J, et al. Imaging of pulmonary mass lesions with whole-body positron emission tomography and fluorodeoxyglucose. Cancer 1993; 72: 82-90.
Rigo P, Paulus P, Kaschten BJ, Hustinx R, Bury T, Jerusalem G, Benoit T, Foidart-Willems J. Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med 1996; 23: 1641-1674.
Patz EF, Lowe VJ, Hoffman JM, et al. Persistent or recurrent bronchogenic carcinoma: detection with PET and 2-(F18)-2-deoxy-\delta-glucose. Radiology 1994; 191: 379-382.
Wahl RL, Quint LE, Greenough RL, et al. Staging of mediastinal non-small cell lung cancer with FDG PET, CT and fusion images: preliminary prospective evaluation. Radiology 1994; 191: 371-377.
Bury T, Corhay JL, Paulus P, et al. La tomographic à émission de positons dans l'évaluation de l'extension ganglionnaire intrathoracique du cancer bronchique non à petites cellules: étude préliminaire chez 30 patients. Rev Mal Respir 1996; 9: 410-114.
Bury T, Paulus P, Dowlati A, et al. Staging of the mediastinum: value of PET imaging in non-small cell lung cancer. Eur Respir J 1996; 9: 2560-2564.
Chin R, Ward R, Keyes J, et al. Mediastinal staging of non-small cell lung cancer with positron emission tomography. Am J Respir Crit Care Med 1995; 152: 2090-2096.
Lewis P, Griffin S, Marsden P, et al. Whole-body 18F-fluorodeoxyglucose positron emission tomography in preoperative evaluation of lung cancer. Lancet 1994; 344: 1265-1266.
Valk P, Pounds T, Hopkins D, et al. Staging of non-small cell lung cancer by whole-body positron emission imaging. Ann Thorac Surg 1995; 60: 1573-1582.
Bury T, Dowlati A, Paulus P, Corhay JL, Hustinx R, Ghaye B, Radermecker M, Rigo P. Whole-body 18FDG positron emission tomography in the staging of non-small cell lung cancer. Eur Respir J 1997; 10: 2529-2534.
Krasnow A, Hellman R, Timins M, Collier D, Anderson T, Isitman A. Diagnostic bone scanning in oncology. Semin Nucl Med 1991; 21: 107-141.
Tisi G, Friedman P, Peters R, Pearson G, Carr D, Lee R, Selawry O. Clinical staging of primary lung cancer. Am Rev Respir Dis 1983; 127: 659-664.
Salvatierra A, Baamonde C, Llamas JM, Cruz F, Lopez-Pujol J. Extrathoracic staging of bronchogenic carcinoma. Chest 1990; 97: 1052-1058.
Napoli LD, Hansen HH, Muggia FM, Twigg HL. The incidence of osseous involvement in lung cancer, with special reference to the development of osteoblastic changes. Radiology 1973; 108: 17-21.
Oyamada H, Tabei Y, Yoneyama T, Eguchi K Orii H, Terni S. Whole-body scintigram and stage classification of patients with adenocarcinoma of the lung. Tohoku J Exp Med 1978; 124: 145-151.
Cowan RJ, Young KA. Evaluation of serum alkaline phosphatase determinations in patients with positive bone scans. Cancer 1973; 32: 887-889.
Warburg O, Wind F, Neglers E. On the metabolism of tumors in the body. In: Warburg O, ed. Metabolism of tumors. London: Constable; 1930:254-270.
Som P, Atkins HL, Bandoypadhyay D et al. A fluorinated glucose analog, 2-fluoro-2-Deoxy-D-glucose (F-18): nontoxic tracer for rapid tumor detection. J Nucl Med 1980; 21: 670-675.
Merrick MV, Merrick JM. Bone scintigraphy in lung cancer: a reappraisal. Br J Radiol 1986; 59: 1185-1194.
Torynos K, Garcia O, Karr B, Le Beaud R. A correlation study of bone scanning with clinical and laboratory findings in the staging of non-small cell lung cancer. Clin Nucl Med 1991; 16: 107-109.
Michel F, Soler M, Imhof E, Perruchoud AP. Initial staging of non-small cell lung cancer: value of routine radioisotope bone scanning. Thorax 1991; 46: 469-473.
Donato A, Ammerman G, Sullesta O. Bone scanning in the evaluation of patients with lung cancer. Ann Thorac Surg 1979; 27: 301-304.
O'Mara R. Skeletal scanning in neoplastic disease. Cancer 1976; 37: 480-486.
