Annals of Nuclear Medicine

, 23:745 | Cite as

Functional imaging in differentiating bronchial masses: an initial experience with a combination of 18F-FDG PET-CT scan and 68Ga DOTA-TOC PET-CT scan

  • Arvind Kumar
  • Tarun Jindal
  • Roman Dutta
  • Rakesh Kumar
Original Article

Abstract

Objective

To evaluate the role of combination of 18F-FDG PET-CT scan and 68Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest.

Study design: Prospective observational study.

Place of study: All India Institute of Medical Sciences, New Delhi, India.

Methods

7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent 18F-FDG PET-CT scan, 68Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor.

Results

Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild 18F-FDG uptake and high 68Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of 18F-FDG and high 68Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of 18F-FDG and no uptake of 68Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild 18F-FDG uptake and no 68Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate 18F-FDG uptake and mild focal 68Ga DOTA-TOC uptake.

Conclusion

This initial experience with the combined use of 18F-FDG and 68Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of 18F-FDG PET-CT scan and 68Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.

Keywords

Bronchial mass 18F-FDG PET-CT 68Ga DOTA-TOC PET-CT 

Notes

Acknowledgments

No financial support is received from any organization for this work.

References

  1. 1.
    Ko JM, Jung JI, Park SH, Lee KY, Chung MH, Ahn MI, et al. Benign tumors of the tracheobronchial tree: CT-pathologic correlation. AJR Am J Roentgenol. 2006;186:1304–13.CrossRefPubMedGoogle Scholar
  2. 2.
    Tripoli JC, Selser RE. The differential diagnosis of lung tumors. Chest. 1941;7:55–9.CrossRefGoogle Scholar
  3. 3.
    Ung YC, Maziak DE, Vanderveen JA, Smith CA, Gulenchyn K, Lacchetti C, et al. 18Fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer: a systematic review. J Natl Cancer Inst. 2007;99(23):1753–67.CrossRefPubMedGoogle Scholar
  4. 4.
    Krüger S, Buck AK, Blumstein NM, Pauls S, Schelzig H, Kropf C, et al. Use of integrated FDG PET/CT imaging in pulmonary carcinoid tumours. J Intern Med. 2006;260:545–50.CrossRefPubMedGoogle Scholar
  5. 5.
    Ishizumi T, Tateishi U, Watanabe S, Maeda T, Arai Y. F-18 FDG PET/CT imaging of low-grade mucoepidermoid carcinoma of the bronchus. Ann Nucl Med. 2007;21:299–302.CrossRefPubMedGoogle Scholar
  6. 6.
    Erasmus JJ, McAdams HP, Patz EF Jr, Coleman RE, Ahuja V, Goodman PC. Evaluation of primary pulmonary carcinoid tumours using FDG PET. AJR Am J Roentgenol. 1998;170:1369–73.PubMedGoogle Scholar
  7. 7.
    Hofmann M, Maecke H, Borner R, Weckesser E, Schoffski P, Oei L, et al. Biokinetics and imaging with the somatostatin receptor PET radioligand (68) Ga-DOTATOC: preliminary data. Eur J Nucl Med. 2001;28:1751–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Hubalewska-Dydejczyk A, Fröss-Baron K, Gołkowski F, Sowa-Staszczak A, Mikołajczak R, Huszno B. 99mTc-EDDA/HYNIC-octreotate in detection of atypical bronchial carcinoid. Exp Clin Endocrinol Diabetes. 2007;115:47–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Slosman DO, Spiliopoulos A, Keller A, Lemoine R, Besse F, Couson F, et al. Quantitative metabolic PET imaging of a plasma cell granuloma. J Thorac Imaging. 1994;9:116–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Terasaki H, Niki T, Hasegawa T, Yamada T, Suzuki K, Kusumoto M, et al. Primary synovial sarcoma of the lung: a case report confirmed by molecular detection of SYT-SSX fusion gene transcripts. Jpn J Clin Oncol. 2001;31:212–6.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2009

Authors and Affiliations

  • Arvind Kumar
    • 1
  • Tarun Jindal
    • 1
  • Roman Dutta
    • 1
  • Rakesh Kumar
    • 2
  1. 1.Department of Surgical DisciplinesAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of Nuclear MedicineAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations