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ABSTRACT: PurposeThe nucleoside analog 3′-deoxy-3′-18F-fluorothymidine (FLT) has been introduced for imaging cell proliferation with positron emission tomography (PET). We prospectively
compared the diagnostic efficacy of FLT PET with that of 2-deoxy-2-18F-fluoro-d-glucose (FDG) PET for the preoperative nodal and distant metastatic staging of non-small cell lung cancer (NSCLC).
MethodsA total of 34 patients with NSCLC underwent FLT PET and FDG PET. PET imaging was performed at 60min after each radiotracer
injection. The PET images were evaluated qualitatively for regions of focally increased metabolism. For visualized primary
tumors, the maximum standardized uptake value (SUV) was calculated. Nodal stages were determined by using the American Joint
Committee on Cancer staging system and surgical and histologic findings reference standards.
ResultsFor the depiction of primary tumor, sensitivity of FLT PET was 67%, compared with 94% for FDG PET (P = 0.005). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for lymph node staging
on a per-patient basis were 57, 93, 67, 89, and 85%, respectively, with FLT PET and 57, 78, 36, 91, and 74%, respectively,
with FDG PET (P > 0.1 for all comparisons). Two of the three distant metastases were detected with FLT and FDG PET.
ConclusionIn NSCLC, FLT PET showed better (although not statistically significant) specificity, positive predictive value and accuracy
for N staging on a per-patient basis than FDG PET. However, FDG PET was found to have higher sensitivity for depiction of
primary tumor than FLT PET.
European journal of nuclear medicine and molecular imaging 04/2012; 35(2):236-245. · 4.99 Impact Factor
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ABSTRACT: An 80-year-old male was admitted because of a giant mass in the left lower lobe of the lung on a routine chest X-ray. Chest computed tomography verified this to be a well-defined heterogeneous mass as described with no associated lymphadenopathy. FDG-PET depicted moderately marginal FDG uptake. The patient underwent a left lower lobectomy and lymphadenectomy. Grossly, the tumor measured 60 × 50 mm and was uniformly filled with a pure white, pudding-like friable substance. No lymph node metastasis was observed microscopically. Histologically, the tumor showed a dense proliferation of rounded or spindled malignant cells with a frequent mitotic activity and an increased nuclear-to-cytoplasmic ratio. The immunohistochemical staining was positive for vimentin, negative for cytokeratin, keratin-wide, EMA, CD34. A SYT-SSX2 fusion gene transcript was detected as a result of RT-PCR analysis. Because of these results, the tumor was diagnosed as a monophasic synovial sarcoma.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 06/2010; 16(3):194-7.
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ABSTRACT: Solitary fibrous tumor of the pleura is one of the uncommon diseases. About 40% of solitary fibrous tumors of the pleura are of a visceral and peduncled type. Several visceral pleural tumors have motility. A proof of motility of the intrathoracic tumor is useful for preoperative diagnosis. We report a resected case of solitary fibrous tumor of the pleura presenting dry cough induced by postural position.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 12/2009; 15(6):401-3.
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ABSTRACT: Empyema with bronchopleural fistula (BPF) is one of the severest complications following pneumonectomy. Many papers have reported that it is difficult to cure, with a high rate of associated mortality. Closure of the fistula and an appropriate choice of obliteration materials are crucial for successful treatment. However, obliteration is sometimes impractical because of a lack of suitable materials, excessive surgical risk, or lack of patient willingness to undergo the procedure. We report a case of post-pneumonectomy empyema with BPF that was treated by non-surgical closure after open-window thoracotomy (OWT) with the use of basic fibroblast growth factor (bFGF), which was sprayed into the unepithelialized empyema cavity transiting from epidermis and surrounding the fistula. After spraying, the orifice of the OWT was covered by a film dressing. This procedure yielded successful results after two months.
Interactive cardiovascular and thoracic surgery 09/2009; 9(5):916-8.
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ABSTRACT: Closure of the fistula and an appropriate choice of obliterating agents are crucial for the treatment of empyema with bronchopleural fistula. The choice of the material to be used for obliteration of the pleural space is a difficult one in some patients, such as those with empyema, developing after omentectomy, laparotomy, posterolateral thoracotomy, and so forth. The use of free anterolateral thigh flaps for obliteration of the pleural space generally needs a satisfactory vascular network around the thorax. We report two successfully treated cases of empyema with bronchial fistula, which were otherwise difficult to manage, in which a free anterolateral thigh musculocutaneous flap anastomosed to the superior thyroid vessels used to obliterate the pleural space.
The Annals of thoracic surgery 06/2009; 87(5):1615-6. · 3.74 Impact Factor
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ABSTRACT: Cancer of the mediastinum is known to be a relatively rare disease, and clear cell carcinoma in the mediastinum is especially rare. Ectopic thymus is not uncommon, but clear cell carcinoma originating from ectopic thymus has never been reported. We report a case of clear cell carcinoma originating from ectopic thymus in which there was a good response to steroid-supplemented chemoradiotherapy.
General Thoracic and Cardiovascular Surgery 06/2009; 57(5):269-71.
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ABSTRACT: Mediastinal tumors are a common condition encountered by general thoracic surgeons, and the most frequent of such tumors is thymoma. However, metastatic mediastinal tumors are rare. Here we report a case of papillary carcinoma of the thyroid to the mediastinum that mimicked thymoma. The patient, a 60-year-old woman who had been treated for thyroid cancer 6 years previously, visited our hospital because of an abnormal shadow in the anterior mediastinum. Radiological findings and laboratory data did not suggest any recurrence of the thyroid cancer, but computed tomography examination revealed a thymoma-like mass. (18)F-Fluoro-2-deoxy-D: -glucose positron emission tomography revealed two lesions: an anterior mediastinal mass and a right breast nodule. We resected both tumors. Histological examination revealed that the mediastinal mass was a metastasis from the thyroid papillary carcinoma, whereas the nodule was an early breast cancer. At the 9-month follow-up examination the patient was well without evidence of recurrence of either cancer.
General Thoracic and Cardiovascular Surgery 11/2008; 56(10):518-20.
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ABSTRACT: Lung segmentectomy is generally considered as a standard procedure in general thoracic surgery. Anatomical variations of pulmonary segmentation may, however, make it difficult to determine the precise area of resection during segmentectomy. Incomplete pulmonary sub-lobar resection may produce unusual radiographic features. Herein, we report a case of bronchial atresia after lung segmentectomy.
Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 09/2008; 14(4):249-51. · 0.69 Impact Factor
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ABSTRACT: The nucleoside analog 3'-deoxy-3'-(18)F-fluorothymidine (FLT) has been introduced for imaging cell proliferation with positron emission tomography (PET). We prospectively compared the diagnostic efficacy of FLT PET with that of 2-deoxy-2-(18)F-fluoro-D-glucose (FDG) PET for the preoperative nodal and distant metastatic staging of non-small cell lung cancer (NSCLC).
A total of 34 patients with NSCLC underwent FLT PET and FDG PET. PET imaging was performed at 60 min after each radiotracer injection. The PET images were evaluated qualitatively for regions of focally increased metabolism. For visualized primary tumors, the maximum standardized uptake value (SUV) was calculated. Nodal stages were determined by using the American Joint Committee on Cancer staging system and surgical and histologic findings reference standards.
For the depiction of primary tumor, sensitivity of FLT PET was 67%, compared with 94% for FDG PET (P = 0.005). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for lymph node staging on a per-patient basis were 57, 93, 67, 89, and 85%, respectively, with FLT PET and 57, 78, 36, 91, and 74%, respectively, with FDG PET (P > 0.1 for all comparisons). Two of the three distant metastases were detected with FLT and FDG PET.
In NSCLC, FLT PET showed better (although not statistically significant) specificity, positive predictive value and accuracy for N staging on a per-patient basis than FDG PET. However, FDG PET was found to have higher sensitivity for depiction of primary tumor than FLT PET.
European journal of nuclear medicine and molecular imaging 02/2008; 35(2):236-45. · 4.99 Impact Factor
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ABSTRACT: Congenital bronchial atresia (CBA) is an infrequent pulmonary anomaly characterized, in general, by a blindly terminating bronchus, mucoid impaction, and hyperinflation of the peripheral pulmonary parenchyma. We herein report an adult case of lobar bronchial atresia who showed no hyperinflation of the peripheral pulmonary parenchyma.
European Journal of Cardio-Thoracic Surgery 09/2006; 30(2):391-3. · 2.55 Impact Factor
