title: Use of FDG PET/CT in Patients with Pancoast Tumors: Does It Add Any Contribution to Patient Management?
abstract: OBJECTIVE
  To evaluate any potential value of 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography/computerized tomography (FDG PET/CT) in staging of patients with Pancoast tumors and to investigate the relationship between volume-based quantitative PET parameters and prognosis.
  
  
  METHODS
  The authors retrospectively reviewed data of the 47 patients with Pancoast tumors who underwent initial staging by conventional imaging methods and FDG PET/CT. FDG-PET images were visually and quantitatively evaluated, and metabolic tumor volume (MTV), total lesion glycolysis, and maximum standardized uptake values of primary tumors were calculated. The correlations between quantitative PET parameters and tumor stages, as well as overall survival, were analyzed.
  
  
  RESULTS
  By detecting unknown distant metastasis, PET/CT upstaged 21% of patients. The sensitivity and specificity for detection of lymphatic involvement were 100% and 83.75%, respectively. Having surgery (p = 0.01) and being at an early stage (p = 0.004) were the most predictive factors for overall survival. Although there was no significant correlation between quantitative PET parameters and overall survival, MTV was the most powerful discriminator for operability and preoperative staging (p < 0.05).
  
  
  CONCLUSIONS
  FDG-PET imaging was found to be a valuable method for an accurate staging in the management of patients with Pancoast tumor. Having surgery and being at an early stage at presentation were found to be significant predictors for survival. Quantitative metabolic parameters may contribute to clarification of operable patient subgroups having an early disease stage with low MTV.
authors.affiliation: 1 Department of Nuclear Medicine, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ozmen
authors.affiliation: 2 Department of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Ulku
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: 3 Department of Radiology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Dadali
authors.affiliation: 1 Department of Nuclear Medicine, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Ebru
authors.initials: E
authors.lastname: Tatci
authors.affiliation: 3 Department of Radiology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Atila
authors.initials: A
authors.lastname: Gokcek
authors.affiliation: 4 Department of Chest Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey .
authors.forename: Ertan
authors.initials: E
authors.lastname: Aydin
authors.affiliation: 5 Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty , Ankara, Turkey .
authors.forename: Kursat
authors.initials: K
authors.lastname: Okuyucu
authors.affiliation: 5 Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty , Ankara, Turkey .
authors.forename: Nuri
authors.initials: N
authors.lastname: Arslan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010178:Pancoast Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 2-deoxy-2-[18F] fluoro-d-glucose; Pancoast tumors; imaging; molecular imaging; positron emission tomography/computerized tomography