The Role of PET-CT-Scan in Evaluation of Bronchogenic Carcinoma in Iraq
Afkar Jawad Abed, Riyadh Waheed AL Esawi, Aws R. Al – Isawi
Currently, fluorodeoxyglucose (FDG) positron emission, its importance has been increasingly in lung cancer. Previous studies and literatures have demonstrated the superior accuracy of FDG-PET than CT-scan in diagnosis, and staging of lung cancers. Nonetheless, still a disadvantage of FDG-PET, in anatomical localization of the pathology. In Iraq, studies concerned with the evaluation of FDG-PET are almost unavailable. Assess the utility of PET-CT in patients with bronchogenic carcinoma for the following: Staging of the bronchogenic carcinoma in Iraq and Follow up of the patients with bronchogenic carcinoma after treatment. This prospective study was involved 100 patients. All patients were referred for PET-CT- scan which are proved by biopsy as Non small lung carcinoma for initial staging with Fluorine-18 fluorodeoxyglucose–Positron Emission Tomography–Computed Tomography- SCAN, out of 100 patients 12 patients followed by another FDG –PET- CT- SCAN six months later after treatment to assess regression or progression of the tumor. Our patients were biopsied either by bronchoscope or CT guided Tru- cut biopsy in Al- Sader medical city in Al- Najaf – radiology department between February 2021- February 2022. The FDG PET –CT SCAN preformed at Amir AL-Momineen speciality hospital oncology & nuclear medicine center. The patients median age was 60 (range 36 – 90) years, and 69% of the patients were older than 50 years. Males represented 70%. Shortness of breath was the main complaint. Secondary lesions reported in 14 cases and were cited in liver, MSK, supra renal gland, and right kidney. Lymphadenopathy (LAP) reported in 37 cases. The mean Standardized Uptake Values was significantly increased with advancing stage, (P. value <0.05). Receiver operating characteristic curve analysis revealed that SUV was good predictor of advanced stage of malignancy, at an optimal cutoff point of 10.5 (SUV). PET -CT –Scan appears to have an important role and performance in evaluation and staging of bronchogenic carcinoma, PET -CT –Scan demonstrated high performance in detection of mediastinal nodal and distant metastasis, and At cutoff value of SUV of 10.5, PET -CT –Scan produce high sensitivity, specificity and accuracy of more than 85%, with low false positive and false negative rates.
Keywords: Bronchogenic carcinoma, FDG-PET CT, Tumor, Lung cancers
