2-fluoro-2-deoxyglucose-6-phosphate and Lung-Neoplasms

Radiofrequency ablation (RFA) for thoracic tumours has emerged as a minimally invasive therapy option for primary and secondary lung tumours and has gained increasing acceptance for pain palliation. The procedure is well tolerated and the complication rates are low. RFA provides the opportunity for localized tissue destruction of limited tumour volumes with medium and long term follow-up data suggesting that survival figures do parallel those of non-surgical treatment modalities. The purpose of this article is to review the status of RFA in lung tumours, to emphasize its place in symptomatic palliation and to discuss its potential role in conjunction with radiation or systemic therapy.

Topics: Carcinoma, Non-Small-Cell Lung; Catheter Ablation; Colorectal Neoplasms; Combined Modality Therapy; Glucose-6-Phosphate; Hemorrhage; Humans; Lung Neoplasms; Palliative Care; Patient Selection; Pleural Effusion; Pleural Neoplasms; Pneumothorax; Prognosis; Tomography, X-Ray Computed; Treatment Outcome

Integrated computed tomography-positron emission tomography (CT-PET) scanners improve localization of regions of increased [18F]-fluoro-2-deoxy-D-glucose (FDG) uptake and staging accuracy by allowing the near-simultaneous acquisition of coregistered, spatially matched functional and morphologic data in the same examination. However, many benign lesions can accumulate FDG and be potential pitfalls in interpretation. With the increased use of CT-PET in oncologic imaging, misinterpretation of these potential pitfalls can have significant clinical ramifications and alter staging and management. In this article, we review the physiologic uptake of FDG, normal variants, and potential pitfalls in the integrated CT-PET imaging of the thorax and their implications in oncologic imaging.

Topics: Artifacts; Carcinoma, Non-Small-Cell Lung; Glucose-6-Phosphate; Humans; Hyperventilation; Image Processing, Computer-Assisted; Lung Neoplasms; Magnetic Resonance Imaging; Muscle, Skeletal; Pleurodesis; Positron-Emission Tomography; Respiration; Respiratory Muscles; Thoracic Neoplasms; Tomography, X-Ray Computed

Focal pulmonary lesions are commonly encountered in clinical practice, and positron emission tomography (PET) with the glucose analog 18-fluorodeoxyglucose (FDG) may be an accurate test for identifying malignant lesions.. To estimate the diagnostic accuracy of FDG-PET for malignant focal pulmonary lesions.. Studies published between January 1966 and September 2000 in the MEDLINE and CANCERLIT databases; reference lists of identified studies; abstracts from recent conference proceedings; and direct contact with investigators.. Studies that examined FDG-PET or FDG with a modified gamma camera in coincidence mode for diagnosis of focal pulmonary lesions; enrolled at least 10 participants with pulmonary nodules or masses, including at least 5 participants with malignant lesions; and presented sufficient data to permit calculation of sensitivity and specificity were included in the analysis.. Two reviewers independently assessed study quality and abstracted data regarding prevalence of malignancy and sensitivity and specificity of the imaging test. Disagreements were resolved by discussion.. We used a meta-analytic method to construct summary receiver operating characteristic curves. Forty studies met inclusion criteria. Study methodological quality was fair. Sample sizes were small and blinding was often incomplete. For 1474 focal pulmonary lesions of any size, the maximum joint sensitivity and specificity (the upper left point on the receiver operating characteristic curve at which sensitivity and specificity are equal) of FDG-PET was 91.2% (95% confidence interval, 89.1%-92.9%). In current practice, FDG-PET operates at a point on the summary receiver operating characteristic curve that corresponds approximately to a sensitivity and specificity of 96.8% and 77.8%, respectively. There was no difference in diagnostic accuracy for pulmonary nodules compared with lesions of any size (P =.43), for semiquantitative methods of image interpretation compared with qualitative methods (P =.52), or for FDG-PET compared with FDG imaging with a modified gamma camera in coincidence mode (P =.19).. Positron emission tomography with 18-fluorodeoxyglucose is an accurate noninvasive imaging test for diagnosis of pulmonary nodules and larger mass lesions, although few data exist for nodules smaller than 1 cm in diameter. In current practice, FDG-PET has high sensitivity and intermediate specificity for malignancy.

Topics: Glucose-6-Phosphate; Humans; Lung Neoplasms; Radiopharmaceuticals; ROC Curve; Sensitivity and Specificity; Solitary Pulmonary Nodule; Tomography, Emission-Computed

Although metabolic modulation in the tumor microenvironment (TME) is one of the key mechanisms of cancer immune escape, there is a lack of understanding of the comprehensive immune landscape of the TME and its association with tumor metabolism based on clinical evidence. We aimed to investigate the relationship between the immune landscape in the TME and tumor glucose metabolism in lung adenocarcinoma.

Topics: Adenocarcinoma of Lung; Decision Support Techniques; Gene Expression Profiling; Glucose; Glucose-6-Phosphate; Humans; Immunity, Cellular; Lung Neoplasms; Neural Networks, Computer; Positron-Emission Tomography; Prognosis; Sequence Analysis, RNA; Survival Analysis; Tumor Microenvironment

Uterine sarcomas are rare and aggressive gynecologic tumors with a poor prognosis because of recurrence and metastasis. However, the mechanisms of uterine sarcoma metastasis are largely unknown. To investigate this mechanism, we developed a novel uterine sarcoma tissue-derived orthotopic and metastatic model in KSN nude mice using a green fluorescent protein stably expressed uterine sarcoma cell line, MES-SA. Histological analysis showed that all orthotopic primary tumors were undifferentiated sarcoma. Primary tumors were characterized by high (18)F-fluorodeoxyglucose uptake with a positive correlation to the number of pulmonary metastases. In addition, we generated uterine sarcoma cell sublines with high or low metastatic potentials by serial in vivo selection. Microarray analysis between orthotopic tumors with high and low metastatic potentials revealed differential expression of genes related to cell proliferation and migration (TNNT1, COL1A2, and ZIC1). Our model would be useful to compensate for the limited clinical cases of uterine sarcoma and to investigate the molecular mechanisms of metastatic uterine sarcoma.

Topics: Animals; Cell Line, Tumor; Disease Models, Animal; Female; Glucose Transport Proteins, Facilitative; Glucose-6-Phosphate; Humans; Lung Neoplasms; Mice; Mice, Nude; Positron-Emission Tomography; Sarcoma; Transcription Factors; Troponin T; Tumor Cells, Cultured; Uterine Neoplasms

Topics: Adult; Glucose-6-Phosphate; Humans; Immunoglobulin kappa-Chains; Incidental Findings; Lung Neoplasms; Male; Plasmacytoma; Positron-Emission Tomography; Radiopharmaceuticals