ORIGINAL ARTICLES   

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2015 December;59(4):446-54

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Fluorodeoxyglucose positron emission tomography in pulmonary carcinoid tumors

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.