The Contribution of Fluorine F-18-FDG PET/CT to Lung Cancer Diagnosis, Staging and Treatment Planning

WOS: 000435003600004PubMed ID: 29889029Objective: Lung cancer is the most common cause of cancer-related death throughout the world, and the correct choice of treatment based on early diagnosis and staging increases the chance of survival. The present study aims to investigate the contribution of fluorine 18-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18-FDG PET/CT) to the management of lung cancer. Methods: In this study, 50 patients who underwent F-18-FDG PET/CT for lung cancer diagnosis and staging between February 2012 and February 2014 were included. The maximum standardized uptake value (SUVmax) of the primary lung lesion along with other findings of F-18-FDG PET/CT and the results of histopathologic and conventional examinations were evaluated retrospectively. The mean survival time of patients was determined, and the findings were compared by using statistical methods. Results: Histopathologic examinations revealed 51 lung cancers in 50 patients. The sensitivity, accuracy and positive predictive value of F-18-FDG PET/CT in detecting primary malignancy were 94%, 94%, 100%, respectively. Adenocarcinoma (n=23, 16.8 +/- 13.5) and squamous cell carcinoma (n=15, 17.9 +/- 5.6) did not differ significantly regarding their mean SUVmax values (p=0.2). A statistically significant positive correlation (r=0.4) was identified between tumor size and SUVmax value for 51 tumors (p=0.002). The F-18-FDG PET/CT result was true negative in nine, false positive in six, true positive in two, and false negative in four patients who underwent histopathologic evaluation of their lymph nodes. The F-18-FDG PET/CT changed treatment planning in 34% of the patients. No significant relationship was identified between SUVmax value of the tumor and patient survival in patients (p=0.118). Conclusion: The present study concluded that PET/CT was an efficient method in the diagnosis and staging of lung cancer since it provided useful information in addition to conventional methods. It was also observed that PET/CT scanning resulted in a change in therapeutic plans in the majority of patients. However, there was no statistically significant relationship between survival and the SUVmax of the primary mass

The role of apelin in the assessment of response to chemotherapy and prognosis in stage 4 nonsmall cell lung cancer

WOS: 000389053000013PubMed ID: 27966297Background/aim: Prediction of response to chemotherapy and prognosis bears clinical significance in patients with lung cancer. The aim of the study was to examine the association between apelin expression in tumor tissues and overall survival, progression-free survival, chemoresistance, and treatment response in stage 4 nonsmall cell lung cancer (NSCLC) patients undergoing chemotherapy. Materials and methods: A total of 81 patients who received chemotherapy due to a biopsy-documented diagnosis of NSCLC between 2004 and 2011 were retrospectively studied. Bronchoscopic biopsy samples were examined immunohistochemically. Results: Of the overall study population (n = 81), the mean age was 59.0 +/- 9.2 years; 83% (n = 67) were male and 17% (n = 14) were female. All patients received chemotherapy. A total of 30 patients (37%) had no apelin positivity, while 21 (30%) had 1 +, 20 (25%) had 2 +, and 10 (12%) had 3 + apelin positivity. We detected no association between apelin positivity and overall survival, 6-month survival, or 1-year survival rates (P = 0.05, 0.74, and 0.63). Patients with apelin expression as compared to those without it had shorter overall survival (P = 0.05). Conclusion: Our results suggest that apelin, an angiogenic factor, does not seem to provide significant prognostic information in this patient group

Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases

WOS: 000328269400062PubMed ID: 23992004Background: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95% CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC

Diagnostic Yield of Bronchoscopy with C-Arm Scopy in Cases without Endobronchial Lesion

WOS: 000376567100007Aim: Fiberoptic bronchoscopy (FOB) is widely used in the diagnosis and treatment of pulmonary diseases. FOB sensitivity is generally low in tumors localized in the outer third of the lung. Diagnosis of peripheral pulmonary lesions can be difficult; however, the use of computed tomography (CT)-, fluoroscopy- or ultrasonography (USG)-guided surgery increases the diagnostic rates. In this study we aimed to compare the diagnostic values of C-arm fluoroscopy-guided bronchoscopic lavage, brushing, and biopsy samples obtained in cases where radiological masses or parenchymal lesions were detected, but endobronchial pathology was not found. Material and Method: In this prospective observational study, bronchoscopy was performed to the patients who had a mass lesion or parenchymal infiltration on chest radiogram and who had no endobronchial lesion, the diagnostic results of the bronchoscopic lavage, brush and biopsy specimens have been compared where C-arm scopy guided the procedures. Results: 60 patients (45 male) with a mean age 61.5 +/- 9.6 were enrolled into the study. The lesions were mostly located in the right upper lobe. 45 patients had peripheral mass lesion, 17 patients had noduler lesion where consolidation or infiltration were present in 18 patients. The diagnostic yield of the bronchoscopic biopsy was 36%, brushing 20% and 21% for the bronchoscopic lavage. Overall diagnostic yield with all bronchoscopic methods was 45%. In lesions with a diameter of <3 cm, bronchoscopic brushing was significantly ineffective. There was not any severe complication due to these procedures. Discussion: The C-arm scopy guided bronchoscopic biopsy was much more valuable in the diagnosis of peripheral lesions

MOLECULAR PROGNOSTIC FACTORS IN NON-SMALL CELL LUNG CANCER PATIENTS WHO RECEIVED CURATIVE RADIOTHERAPY AND CHEMOTHERAPY

WOS: 00029176980012

Evaluation of dose-volume histograms and related pulmonary side effects in lung cancer patients treated with 3-D conformal radiotherapy

WOS: 00026949600275

Predictors of Clinical Outcome in Acute Pulmonary Embolism: Correlation of CT Pulmonary Angiography with Clinical, Echocardiography and Laboratory Findings

WOS: 000286018600007PubMed ID: 21036631Rationale and Objectives: The aims of this study were to retrospectively evaluate whether computed tomographic (CT) parameters were predictors of in-hospital mortality within 30 days of CT imaging and to compare CT parameters with clinical, echocardiographic, and laboratory findings in patients with acute pulmonary embolism (PE). Materials and Methods: A total of 122 patients (61 women, 61 men; mean age, 64 +/- 15 years) with CT scans positive for acute PE were reviewed. Two independent readers who were blinded to clinical outcomes scored pulmonary artery obstructions, evaluated cardiovascular measurements, and assessed qualitative findings. Reports of echocardiographic, clinical, and laboratory findings and clinical outcome were reviewed. Results were correlated with patient outcomes using Wilcoxon's rank-sum, chi(2), and Student's t tests. Logistic regression analyses were performed to determine predictors of patient outcomes. Results: Thirteen patients (11%) died related to PE within 30 days in the hospital. There were significant differences in the ratio of arterial partial pressure of oxygen to inspired fraction of oxygen and in heart rate between survivors and nonsurvivors (P < .05). No CT or echocardiographic predictor was associated with mortality. Conclusions: The ratio of arterial partial pressure of oxygen to inspired fraction of oxygen and heart rate strongly predicted mortality due to PE. Neither CT pulmonary angiographic variables nor echocardiography could successfully predict in-hospital mortality in patients with acute PE