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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
Online ISSN 1827-1936
Gasparri R. 1, Rezende G. C. 1, Fazio N. 2, Maisonneuve P. 3, Brambilla D. 1, Travaini L. L. 4, Paganelli G. 5, Petrella F. 1, Galetta D. 1, Spaggiari L. 1, 6
1 Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy;
2 Unit of Gastrointestinal Medical Oncology and Neuro-endocrine Tumors, European Institute of Oncology, Milan, Italy;
3 Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy;
4 Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy;
5 Unit of Nuclear Medicine, Istituto Scientifico Romagnolo IRST, IRCCS, Meldola, Forlì, Italy;
6 DIPO Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
AIM: The role of fluorodeoxyglucose positron emission tomography (FDG-PET) as an additional investigation to computer tomography for pulmonary carcinoid tumors remains controversial. The aim of this study was to assess the role of FDG-PET for the diagnosis and staging of pulmonary carcinoid tumors.
METHODS: We performed a retrospective mono-institutional analysis of data from 97 patients with pathologically confirmed pulmonary carcinoid tumor who had been operated on between July 1998 and April 2009 and had had a preoperative FDG-PET scan performed.
RESULTS: Sixty-five (67%) of the 97 tumors were typical (TC) and 32 (33%) atypical (AC) carcinoid tumors. Overall FDG-PET sensitivity was 67% being lower for TC (60%) than for AC (81%) (P=0.04). FDG-PET negative tumors were smaller than FDG-PET positive tumors, with a respective median size of 15 and 17 mm (P=0.02). Median SUVmax for FDG-PET-positive tumors was 4.0 (2.8-5.1) with no difference between TC and AC tumors. Median Ki-67 expression was respectively 4.7% and 3.1% for FDG-PET positive and FDG-PET negative tumors (P=0.05). During a median follow-up of 49 months (interquartile range 30-63 months), 9 patients (4TC, 5AC) developed recurrent disease. Neither SUVmax nor Ki-67 expression resulted associated with disease-free survival.
CONCLUSION: With an overall sensitivity of 67%, FDG-PET has shown to be useful in the preoperative work-up of patients with suspect lung carcinoid tumors. In particular it could have a role in larger tumors. These results warrant a prospective evaluation of FDG-PET in the staging of lung carcinoid tumor.