Hybrid Imaging for Tumours of the Chest

Lung cancer (LC) is a fairly common malignancy. Cancer stage at diagnosis, which refers to the extent of a cancer in the body, determines treatment options and has a strong influence on the length of survival. Diagnostic imaging for patients with lung can

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Roberto C. Delgado Bolton and Adriana K. Calapaquí Terán

Contents 22.1     Lung Cancer 22.1.1  Epidemiology of Lung Cancer 22.1.2  Classification of Lung Cancer 22.1.3  Diagnosis 22.1.4  Recurrent Lung Cancer 22.1.5  Appropriate Use Criteria

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22.2     [18F]FDG PET/CT Procedure, Data Processing, Interpretation, and Reporting

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22.3     Initial Staging of Lung Cancer

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22.4     Restaging for Detection of Local Recurrence 22.4.1  Restaging After Initial Treatment (Surgery, Chemoradiotherapy or Radiotherapy) 22.4.2  Restaging After Surgery 22.4.3  Restaging After Stereotactic Body Radiation Therapy 22.4.4  Restaging After Radiofrequency Ablation or Microwave Ablation 22.4.5  Cost-Effectiveness

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22.5     Restaging for Detection of Metastases

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22.6     Treatment Response Evaluation

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22.7     Mesothelioma

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22.8     Other Thoracic Tumours 22.8.1  Thymoma 22.8.2  Teratomas

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22.9     Conclusions

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References

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Learning Objectives

R. C. Delgado Bolton (*) Department of Diagnostic Imaging and Nuclear Medicine, University Hospital San Pedro and Center for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain A. K. Calapaquí Terán Department of Pathology, University Hospital Marqués de Valdecilla (HUMV), Santander, Cantabria, Spain

• Present the main features on epidemiology, presentation, and clinical evolution patterns for tumours of the chest, including lung cancer, malignant pleural mesothelioma, and mediastinal tumours. • Briefly discuss, for each type of tumour of the chest, the role of non-radionuclide imaging techniques (plain X-ray, CT, CECT, MRI) in the initial diagnostic approach, as well as for staging, restaging, and assessment of response to therapy. • Discuss the residual role of bone scintigraphy with 99mTc-­ bisphosphonates or with [18F]fluoride PET/CT in patients with lung cancer.

© Springer Nature Switzerland AG 2019 D. Volterrani et al. (eds.), Nuclear Medicine Textbook, https://doi.org/10.1007/978-3-319-95564-3_22

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• Discuss the role of perfusion scintigraphy as part of preoperative evaluation for patients with lung cancer. • Describe the methodology of performing [18F]FDG PET/ CT (with either low-dose CT and/or CECT) in patients with tumours of the chest. • Indicate the methodology for interpreting and reporting the results of [18F]FDG PET/CT in patients with tumours of the chest. • Discuss the issues regarding definition of appropriate use criteria for patients with tumours of the chest. • Discuss the roles and clinical impact of [18F]FDG PET/ CT during the clinical course of disease (for diagnosis, staging, restaging, assessment of response to therapy) in patients with tumours of the chest including lung cancer, malignant pleural mesothelioma, and mediastinal tumours. • Discuss and compare the performance of PERCIST versus RECIST criteria for assessing response to treatment in patients with lung cancer. • Discuss the pot