TITLE:
The Role of PET/CT Imaging in Lung Cancer
AUTHORS:
David Ladrón de Guevara Hernández
KEYWORDS:
Lung Cancer, Pulmonary Malignancy, PET/CT
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.8,
August
3,
2015
ABSTRACT: Lung cancer
presents a high prevalence around the world and constitutes the leading cause
of death due to cancer in men and women. Proper staging is essential in order
to provide the correct treatment and estimate survival. PET/CT imaging is the
method of choice for the staging of lung cancer patients with a better
performance than the traditional imaging methods. It allows defining the
primary tumor more clearly, separating it from the atelectasis and neighboring
fibrotic changes, thus achieving an improved T evaluation while optimizing the
target definition for radiotherapy. It presents greater sensibility and
specificity than Computed Tomography (CT) when assessing the extra-thoracic and
thoracic lymph nodes, modifying the N stage with regard to the traditional
study in up to 25% of patients. PET/CT imaging is the method with the best
performance for detecting extra-encephalic metastasis and for detecting
unexpected lesions in up to 30% of patients. In order to achieve proper
encephalic staging, a Magnetic Resonance Imaging scan must be performed or, a
CT scan of the brain concomitant to the PET/CT. One to eight percent of lung
cancer patients who are subjected to PET/CT imaging present a synchronous
secondary extra pulmonary or pulmonary cancer when being diagnosed, with
significant prognostic and therapeutic implications. PET/CT imaging has proven
to be a valuable tool for survival prognosis with regard to the initial uptake
of the tumor and the early response (interim) or final response to
chemotherapy, although it is not routinely used for evaluating therapy. The
PET/MRI is an emerging hybrid technique with certain advantages, such as less
exposure to radiation in comparison to PET/CT and greater contrast resolution
of the MRI images. However, its usefulness has not been validated yet for lung
cancer patients.