Keywords :
Non small cell carcinoma; Malignant tumor; Radionuclide study; Bronchus disease; Lung disease; Respiratory disease; Human; Diagnosis; Exploration; Positron; Emission tomography; Relapse; Bronchopulmonary; Carcinome non petite cellule; Tumeur maligne; Exploration radioisotopique; Bronche pathologie; Poumon pathologie; Appareil respiratoire pathologie; Homme; Diagnostic; Positon; Tomoscintigraphie; Récidive; Bronchopulmonaire
Abstract :
[en] In order to evaluate the usefulness of 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the assessment of therapeutic effects, a study was performed before and after therapy in 126 patients with non-small cell lung cancer (NSCLC) codified stage I to stage IIIB. Treatment with an early curative result was given in 58 patients, whereas in 68 cases it was limited to palliation. During the treatment follow-up period (8-40 months), each patient was evaluated every 3 months by clinical examination and ≤6 months by imaging techniques (PET and computed tomography (CT)). A diagnosis of persistent or recurrent tumour was established by means of pathological analysis in 31 patients and by clinical evolution and subsequent imaging progression in 29 other patients. PET showed increased FDG uptake in all cases (n=60) of persistent or recurrent tumour, whereas CT was nonspecific in 17 cases. Conversely, there were five false positive cases via PET imaging and three via CT. In detecting residual or recurrent NSCLC, PET had a sensitivity of 100% and specificity of 92%, whereas CT had a sensitivity and specificity of 71% and 95% respectively. In conclusion, 18-fluorodeoxyglucose positron emission tomography correctly identified response to therapy in 96% (121 of 126) of patients. Positron emission tomography appears to be more accurate (p=0.05) than conventional imaging in distinguishing persistent or recurrent tumour from fibrotic scar in patients undergoing treatment for non-small cell lung cancer.
[fr] Afin d'évaluer l'utilité du 18-fluorodeoxyglucose (FDG) en tomographie par émission de positons (PET) dans l'évaluation des effets thérapeutiques, une étude a été réalisée avant et après la thérapie chez 126 patients atteints de cancer non à petites cellules (CBNPC) a codifié la phase I au stade IIIB. Treatment with an early curative result was given in 58 patients, whereas in 68 cases it was limited to palliation. Le traitement avec un résultat curatif précoce a été donnée chez 58 patients, tandis que dans 68 cas il a été limité aux soins palliatifs. During the treatment follow-up period (8-40 months), each patient was evaluated every 3 months by clinical examination and < or =6 months by imaging techniques (PET and computed tomography (CT)). Durant le traitement, la période de suivi (8-40 mois), chaque patient a été évaluée tous les 3 mois par examen clinique et <ou = 6 mois par des techniques d'imagerie (TEP et tomodensitométrie (CT)). A diagnosis of persistent or recurrent tumour was established by means of pathological analysis in 31 patients and by clinical evolution and subsequent imaging progression in 29 other patients. Un diagnostic de tumeur persistante ou récurrente a été établie au moyen d'analyse pathologique chez 31 patients et par l'évolution clinique et la progression ultérieure d'imagerie dans 29 autres patients. PET showed increased FDG uptake in all cases (n = 60) of persistent or recurrent tumour, whereas CT was nonspecific in 17 cases. PET FDG uptake montré augmenté dans tous les cas (n = 60) de tumeur persistante ou récurrente, alors que le scanner est non spécifique dans 17 cas. Conversely, there were five false positive cases via PET imaging and three via CT. Inversement, il ya eu cinq cas de faux positifs par imagerie PET et trois via CT. In detecting residual or recurrent NSCLC, PET had a sensitivity of 100% and specificity of 92%, whereas CT had a sensitivity and specificity of 71% and 95% respectively. Dans la détection des CBNPC résiduel ou récurrent, le PET a une sensibilité de 100% et une spécificité de 92%, alors que le scanner avait une sensibilité et une spécificité de 71% et 95% respectivement. In conclusion, 18-fluorodeoxyglucose positron emission tomography correctly identified response to therapy in 96% (121 of 126) of patients. En conclusion, 18-fluorodeoxyglucose tomographie par émission de positons correctement identifié la réponse au traitement dans 96% (121 sur 126) des patients. Positron emission tomography appears to be more accurate (p = 0.05) than conventional imaging in distinguishing persistent or recurrent tumour from fibrotic scar in patients undergoing treatment for non-small cell lung cancer. Tomographie par émission de positons semble être plus précis (p = 0,05) que l'imagerie conventionnelle dans la distinction des tumeurs persistants ou récurrents de cicatrice fibreuse chez les patients subissant un traitement pour cancer non à petites cellules du poumon.
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