48P - Evaluation of neoplasms incidentally detected by preoperative FDG-PET/CT for primary lung cancer

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Imaging, Diagnosis and Staging
Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Yuki Noda
Citation Annals of Oncology (2017) 28 (suppl_2): ii14-ii16. 10.1093/annonc/mdx086
Authors Y. Noda1, H. Matsudaira2, S. Arakawa2, K. Yoshida2, T. Morikawa2
  • 1Department Of Surgery, Jikei University School of Medicine, 135-0061 - Tokyo/JP
  • 2Jikei University School of Medicine, Tokyo/JP

Abstract

Background

Fluorodeoxyglucose Positron emission tomography/computed tomography (FDG-PET/CT) is an effective modality generally used in preoperative evaluation for primary lung cancer. In some cases, FDG-PET/CT found incidental neoplastic lesions and also detected unexpected pre-malignancy or second malignancy. Our study aimed to examine incidental findings detected by preoperative PET/CT and its impact on management for lung cancer.

Methods

From April 2010 until August 2015, 149 patients underwent surgery for primary lung cancer at Katsushika Medical Center and 111 patients of them acquired preoperative PET/CT were evaluated retrospectively. Incidental findings were followed up by some imaging test, clinician feedback, pathological examination and various endoscopy.

Results

The objects included 32 women and 79 men. The mean age was 70.6±8.46 years old. Excluding known diseases and thoracic cage lesions, abnormal FDG uptakes on PET/CT observed at 40 patients (36%). 8 cases (7.2%) of them required other modalities for further evaluation and the sites of abnormal uptake were prostate, larynx, thyroid gland, 3 cases of colon, bone and lymph node each.3 cases (2.7%) of colon had an indication for treatment. 2 cases were colon polyp and the other case was colon cancer. 2 cases underwent endoscopic mucosal resection. The other case underwent surgery for the colon cancer before treatment for the lung cancer because of neoplastic obstruction. This case was pointed out liver metastasis 6 months later from surgery of the colon cancer. We diagnosed liver lesion as colon cancer metastasis and we are doing chemotherapy to this case.

Conclusions

A malignant or pre-malignant lesion was found in 0.9% and 1.8%, respectively. Colon was major lesion of abnormal uptake of FDG in our study, and 1 case required colon resection before lung cancer. The case had a significant change in management for treatment. We conclude preoperative FDG PET/CT might be useful modality in identifying second primary cancers or pre-malignancy lesions in patients with primary lung cancer. Further investigations are needed to evaluate incidental findings detected by preoperative FDG PET/CT.

Clinical trial identification

Legal entity responsible for the study

Jikei University School of Medicine

Funding

Jikei University School of Medicine

Disclosure

All authors have declared no conflicts of interest.