Oncological applications of positron emission tomography for evaluation of the thorax

Our plain-English summary of Oncological applications of positron emission tomography for evaluation of the thorax, by T.C. Kwee, D.A. Torigian, A. Alavi (Journal of Thoracic Imaging, 2013).

The study

• Authors: T.C. Kwee, D.A. Torigian, A. Alavi
• Journal: Journal of Thoracic Imaging
• Published: 2013;28(1):11-24
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Positron emission tomography is a powerful quantitative molecular imaging technique that is complementary to structural imaging techniques for purposes of disease detection and characterization. This review article will provide an overview of the applications of positron emission tomography for evaluation of patients with oncological diseases that may be encountered in the thorax.

In plain English

This article is a review, not an original study. The authors, from radiology departments in Utrecht and Philadelphia, gave an overview of how positron emission tomography (PET) is used for cancers in the chest, mainly PET with the radioactive sugar tracer 18F-FDG. They covered screening, assessing single lung nodules, staging, tumor biology, radiation therapy planning and checking response to treatment. They also discussed specific cancers: lung cancer, malignant pleural mesothelioma, lymphoma, thymic tumors and breast cancer. The article does not mention asbestos. On malignant pleural mesothelioma, the authors cited an earlier systematic review that concluded the main roles of PET/CT are staging before surgery, assessing treatment response and follow-up after treatment. They wrote that telling mesothelioma apart from benign pleural disease remains challenging. They noted that cited studies linked high tracer uptake in mesothelioma to poor outcome. Because most patients die within 1 year of diagnosis, they called it debatable whether PET is useful and cost-effective in mesothelioma. The authors concluded that PET complements structural imaging for detecting and characterizing disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review article (no original data)
• Who was studied: No study population of its own; the review covered published research on PET in thoracic cancers, including lung cancer, malignant pleural mesothelioma, lymphoma, thymic epithelial tumors and breast cancer
• Exposure: No asbestos or other exposure was studied; the subject is an imaging technique (18F-FDG PET and PET/CT, plus other PET tracers)
• Main results:
  • Citing an earlier systematic review, the authors reported that the major roles of 18F-FDG PET/CT in malignant pleural mesothelioma include preoperative staging, treatment response assessment, and posttreatment disease surveillance
  • The authors wrote that distinguishing malignant pleural mesothelioma from benign pleural disease with PET remains challenging, although limited studies have shown promising results
  • Citing other studies, the authors stated that high 18F-FDG uptake in malignant pleural mesothelioma is significantly associated with a poor outcome
  • The authors noted that most mesothelioma patients die within 1 year of diagnosis, and called it debatable whether 18F-FDG PET is a useful, cost-effective method in this disease
  • The authors described 18F-FDG PET as an established method for staging thoracic cancers, with non-small cell lung cancer as the main example
  • The authors judged it unlikely that 18F-FDG PET will be used more widely for lung cancer screening in the near future
• The authors' conclusion: The authors concluded that PET is a powerful quantitative molecular imaging technique that is complementary to structural imaging techniques for detecting and characterizing disease
• Limitations the authors state:
  • The authors state that the article highlights only a selection of PET applications
  • The authors state that they could not discuss all non-18F-FDG radiotracers in the article

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Thorax.

Related studies

• 18-Fluorodeoxyglucose positron emission tomography as a tool for response prediction in solid tumours — D.J. De Maeseneer, B. Lambert, et al. (2010)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)
• Relationship between 18F-FDG uptake on positron emission tomography and molecular biology in malignant pleural mesothelioma — K. Kaira, M. Serizawa, et al. (2012)
• Does positron emission tomography offer prognostic information in malignant pleural mesothelioma? — S. Sharif, I. Zahid, et al. (2011)
• Integrated positron emission tomography-computed tomography does not accurately stage intrathoracic disease of patients undergoing trimodality therapy for malignant pleural mesothelioma — J. Pilling, J.A. Dartnell, et al. (2010)
• 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography fused imaging in malignant mesothelioma patients: looking from outside is not enough — E. Roca, S. Laroumagne, et al. (2013)

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