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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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