Document Detail

FDG PET-CT aids in the preoperative assessment of patients with newly diagnosed thymic epithelial malignancies.
MedLine Citation:
PMID:  23446204     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Advanced thymoma (stage III and IV) is difficult to detect by computed tomography (CT), yet it is important to distinguish between early (stage I and II) and advanced disease before surgery, as patients with locally advanced tumors require neoadjuvant chemotherapy to enable effective resection. This study assessed whether the amount of fluorodeoxyglucose (FDG) uptake can predict advanced thymoma and whether it can separate thymoma from thymic cancer.
METHODS: We retrospectively reviewed FDG positron emission tomography (PET)-CT scans of 51 consecutive newly diagnosed patients with thymic epithelial malignancy. PET-CT findings documented focal FDG activity: SUVmax, SUVmean, SUVpeak, and total body volumetric standardized uptake value (SUV) measurements. These were correlated with Masaoka-Koga staging and World Health Organization classification. Wilcoxon ranked sum tests were used to assess association between SUV and pathological stage, cancer type, and classification.
RESULTS: Among the study patients, 37 had thymoma, 12 thymic carcinoma, and 2 thymic carcinoid. Higher focal FDG uptake was seen in patients with type B3 thymoma than in those with type A, AB, B1, or B2 thymoma (p < 0.006). FDG uptake was higher in patients with thymic carcinoma or carcinoid than in patients with thymoma (p < 0.0003), with more variable associations with volumetric SUV measurements. There was no significant association observed between higher focal FDG uptake and advanced-stage disease in thymoma patients (p > 0.09), although greater FDG-avid tumor volume was significantly associated with advanced disease (p < 0.03).
CONCLUSIONS: Focal FDG uptake cannot predict advanced thymoma but is helpful in distinguishing thymoma from thymic carcinoma, or the more aggressive thymoma, type B3.
Marcelo F K Benveniste; Cesar A Moran; Osama Mawlawi; Patricia S Fox; Stephen G Swisher; Reginald F Munden; Edith M Marom
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  8     ISSN:  1556-1380     ISO Abbreviation:  J Thorac Oncol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-14     Completed Date:  2013-09-12     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  502-10     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Carcinoid Tumor
Fluorodeoxyglucose F18 / diagnostic use*
Follow-Up Studies
Middle Aged
Neoplasm Staging
Neoplasms, Glandular and Epithelial / diagnosis*,  surgery
Positron-Emission Tomography*
Preoperative Care
Radiopharmaceuticals / diagnostic use*
Retrospective Studies
Thymoma / diagnosis*,  surgery
Thymus Neoplasms / diagnosis*,  surgery
Tomography, X-Ray Computed*
Young Adult
Grant Support
P30 CA016672/CA/NCI NIH HHS; P30 CA016672/CA/NCI NIH HHS
Reg. No./Substance:
0/Radiopharmaceuticals; 0Z5B2CJX4D/Fluorodeoxyglucose F18

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