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FDG Case: Lung Cancer Staging

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This is a case of a 62-year-old female

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with a smoking history

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that was enrolled on a CT lung cancer screening program

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and she was found to have a

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lung nodule in the right lower lobe, very close

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to the bronchovascular bundle, as well as other

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smaller nodules.

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These raise the concern for a malignancy and

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therefore an FDG PET CT was recommended.

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Here we have the F DG PET CT in which we can see

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that there is very intense tracer uptake corresponding to

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that lung nodule.

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The other nodules that we're seeing like this one

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that I'm showing you here, it's a smaller,

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has no tracer uptick,

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and there were other areas of bronchial valve thickening in

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that same right lower lobe

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that didn't have tracer uptake either.

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These intensely FDG AVID lesion

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had an SUV max of 9.2.

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Aside from that finding, there was no other

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abnormality seen in the mediastinum, no

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concerning lymph nodes

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and no concerning distant disease elsewhere.

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This patient underwent a biopsy

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and the biopsy revealed, uh, small cell carcinoma,

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which is an aggressive type of neuroendocrine tumor.

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You would wonder why wouldn't we do a ity

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to stage this patient and is

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because these aggressive neuroendocrine tumors

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are going to most likely be seen with a sensitive

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tracer such as a DG rather than with

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a specific one like dotatate.

Report

Faculty

Elisa Franquet Elia, MD

Assistant Professor of Radiology

UMass Chan Medical School

Tags

PET/CT FDG

PET

Oncologic Imaging

Nuclear Medicine

Neoplastic

Lungs

General Oncologic Imaging Concepts

Chest