Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/30396
Title: An exceptional group of non-small cell lung cancer difficult to diagnose: Evaluation of lipid-poor adrenal lesions
Authors: Şimsek, Fikri Selçuk
Arslan, Muhammet
Dağ, Yusuf
Keywords: 18F-FDG-PET/CT
Adrenal lesion
Diagnostic difficulties
Lipid-poor
NSCLC
fluorodeoxyglucose f 18
lipid
adrenal tumor
aged
biopsy
chemistry
diagnostic imaging
female
glucose blood level
human
lung tumor
male
metastasis
middle aged
non small cell lung cancer
positron emission tomography-computed tomography
predictive value
receiver operating characteristic
retrospective study
sensitivity and specificity
tumor cell line
Adrenal Gland Neoplasms
Aged
Biopsy
Blood Glucose
Carcinoma, Non-Small-Cell Lung
Cell Line, Tumor
Female
Fluorodeoxyglucose F18
Humans
Lipids
Lung Neoplasms
Male
Middle Aged
Neoplasm Metastasis
Positron Emission Tomography Computed Tomography
Predictive Value of Tests
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Publisher: Association of Basic Medical Sciences of FBIH
Abstract: In some non-small cell lung cancer (NSCLC) patients, lipid-poor adrenal adenomas cannot be adequately differentiated from metastases using imaging methods. Invasive diagnostic procedures also have a low negative predictive value (NPV) in such cases. The current study aims to establish a specific and clinically practical metabolic parameter for lipid-poor adrenal lesions (ALs) in NSCLC patients. This diagnostic approach may prevent unnecessary abdominal enhanced computed tomography (CT), magnetic resonance imaging, or invasive diagnostic procedures. Sixty-four NSCLC patients with 69 lipid-poor ALs and 28 control patients with 30 benign lipid-poor ALs, who underwent FDG-PET/CT, were retrospectively reviewed. Two morphological and four metabolic parameters were analyzed in FDG-PET/CT images of NSCLC and control patients. Baseline and post-chemotherapy images of 64 NSCLC patients were re-evaluated according to the PERCIST 1.0. In cases where ALs could not be differentiated, follow-up FDG-PET/CT images were re-examined. The receiver operating characteristic (ROC) curve method was used for the evaluation of diagnostic parameters. Out of 69 ALs, 39 were determined as metastatic lesions (adrenal metastasis), while 30 lesions were considered non-metastatic (adrenal adenomas). The mean attenuation value, SUVmax AL/SUVmax primary tumor, SUVmax, SUVmax AL/liver, and SUVmax AL/SUVmean liver were significantly different between metastatic and benign ALs from NSCLC patients. The SUVmax AL/SUVmean liver ?1.81 had the best positive (PPV, 94.3%) and negative (NPV, 82.4%) predictive values, and the highest specificity (93.3%), sensitivity (84.6%) and accuracy (86.9%). Lipid-poor ALs with SUVmax AL/SUVmean liver ?1.81 can be accepted as malignant in NSCLC. However, if SUVmax AL/SUVmean liver is <1.81, a pathologic examination is required. Utilizing this cut-off value to decide on adrenal core biopsy may prevent its unnecessary use. Moreover, this diagnostic approach can save time and reduce the healthcare costs. © 2019 ABMSFBIH.
URI: https://hdl.handle.net/11499/30396
https://doi.org/10.17305/bjbms.2019.3837
ISSN: 1512-8601
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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