Chest
Clinical Investigations: CancerClinical Role of F-18 Fluorodeoxyglucose Positron Emission Tomography Imaging in Patients with Lung Cancer and Suspected Malignant Pleural Effusion
Section snippets
Patient Population
We identified 35 consecutive patients with proven lung cancer who underwent PET-FDG imaging for suspected malignant pleural effusion or pleural metastases. All these patients either had conclusive pleural fluid cytology or clinical follow-up for at least 12 months, which confirmed the malignant or benign nature of etiology. Patients who did not have pleural cytology or definitive evidence of malignancy or benignity on follow-up were excluded from our study; therefore, patients with unsuccessful
Results
We studied 35 patients with radiographic findings of pleural effusion and/or pleural nodular involvement on chest radiography and/or CT with proven lung cancer at the time of study or previously. Of 35 patients, 18 patients had evidence of malignant effusion either on histology and clinical follow-up (n = 16) or clinical follow-up (n = 2), while 17 patients had either negative histology (n = 16) or clinical follow-up (n = 1) [Table 1].
Discussion
Pleural involvement is not an uncommon finding in patients with lung carcinoma. However, differentiation between benign and malignant effusion may be critical for accurate determination of the resectable status of the lung tumor. Most lung cancer patients may have potentially unresectable disease in the presence of malignant pleural effusions. Similarly it is very useful to diagnose the benign etiology of pleural effusion to prevent delay in the surgical treatment of resectable lung cancer.
Conclusion
In summary, PET-FDG may be a useful noninvasive diagnostic test for evaluation of pleural effusions in patients with lung cancer. Incorporation of PET-FDG imaging in the diagnostic algorithm used for differentiating benign from malignant effusion may improve the accuracy of staging of patients with lung cancer. PET-FDG may provide a useful alternate diagnostic method to invasive tests in patients with suspected malignant pleural effusion especially in patients with equivocal findings on CT or
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Positron Emission Tomography
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