PET/CT in lung cancer with brain metastases
N.Georgieva, Zh. Dancheva, B. Chaushev, A. Klisarova, B. Balev,K. Peeva
PET/CT is a method for diagnosis, staging and evaluating the effect of lung cancer treatment. The lung cancer is one of the cancers with most frequent localization of the metastases in brain. We have studied with 18 FDG-РЕТ/СТ 45 patients, 26 male (57.8%) and 19 female (42.2%) between 41 to 71 years of age, diagnosed with non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC) and brain metastases by 63 examinations. Examinations have been executed on integrated apparatus Phillips Gemini TF (2009). 18FDG has been applied by i.v. injection with activity 0.14 mCi/kg. Patients are staged by TNM classification. Survival has been evaluated by Kaplan-Meier method, for comparison of studied groups the log rank (Mantel-Cox) has been applied. (P<0.05) Multiple metastases in brain have been detected in 8 patients (17%). Hypo-metabolic have been found in 7 patients (14.9%), with hyper-metabolic – 10 (21.3%), with ring-like – 7 (14.9%). In patients with metastases operated on, in the area of the operative intervention a hypo-metabolic zone has been found. New metastases have been found in 3 patients after operation. The median of survival of the patients with NSCLC in months for stage II and III has been estimated to 25.2 months and for stage IV to 12.9 months and total survival to 16.8 months (P=0.03). The median of survival in months for patients with NSCLC and SCLC in II and III stage is estimated to 28.4 months, for stage IV is estimated to 12.4 months and total survival is estimated to 16.8 months (P=0.04) Survival of the patients with NSCLC and SCLC with brain metastases is significantly dependent on the clinical stage. The median of survival in patients to III stage is double times longer than the median of survival of patients in IV stage. The median of total survival is estimated to 16.8 months. Most common histological form of the lung cancer in case of metastases in brain is adenocarcinoma. The established by PET/CT lesions in asymptomatic patients change the staging and in some cases therapeutic management.
Key words: LUNG CARCINOMA. BRAIN METASTASIS. PET/CT