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iRECIST criteria for follow-up of patients who are on immunotherapy. iCR, immune complete response; iPR, immune partial response; iSD, immune stable disease.
Source publication
Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenoca...
Citations
... Guidelines recommend a contrast-enhanced CT (CECT) scan of the chest and upper abdomen (including the adrenal glands) for further evaluation. In patients who are eligible for curative treatment in addition to having no signs of metastasis on CT scan, an FDG-PET/CT is suggested [11]. ...
Background
Early staging of lung carcinoma (CA) is pivotal in planning the treatment. Lymph node metastasis can be detected by imaging and invasive procedures. The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is an emerging noninvasive imaging modality in detecting nodal metastasis.
Objective
This study aimed to determine the usefulness of the FDG-PET/CT scan in detecting subcentimeter mediastinal lymph node involvement in lung CA patients by taking histopathology as the gold standard.
Materials and methods
We conducted a retrospective cross-sectional study at a tertiary care cancer hospital in Pakistan over four and half years, from January 2015 to June 2019. All patients suffering from non-small cell lung CA (NSCLC) having avid subcentimeter nodes on FDG-PET/CT were included. The findings obtained on FDG-PET/CT were correlated with histopathological findings after endobronchial ultrasound (EBUS). The results were formulated using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States).
Results
Results showed that 42/380 total lung CA patients had avid subcentimeter lymph nodes obtained on FDG-PET/CT. A total of 22/42 (52.4%) lymph nodes appeared to be benign, and 20/42 (47.6%) lesions were malignant on histopathology. FDG-PET/CT sensitivity is calculated to be 95%, specificity is 68%, positive predictive value is 73%, negative predictive value is 94%, and accuracy is 80.9%. Using the receiver operating characteristic (ROC) curve, sensitivity and specificity were seen in nodes of size 7.5 mm and the maximum standardized uptake value (SUV max) of 5.5 as cutoff values as manifested by area under the curve (AUC).
Conclusion
FDG-PET/CT was proven to have high sensitivity and accuracy but a low specificity rate to detect nodal involvement in lung CA patients. The high false-positive rates are mainly due to increased prevalence of endemic lung infectious disease.
... Contrastenhanced CT (CECT) and 18 F-FDG PET-CT (positron emission tomography with 2-deoxy-[fluorine-18] Fluoro-D-glucose integrating CT) has no metastatic spread indication in patients and is also the most accurate investigating method. Esophagitis, Pneumonitis, cardiac disease, and pulmonary artery thrombosis have been reported as radiotherapy obstacles [76]. Microfluidic platforms revolutionized 3D cultures over conventional 2D systems enabling manipulation of fluid, maintenance of controlled temperature for drug delivery mimicking mechanism taking place in in vivo conditions [65]. ...
... Occasionally, a CT examination of endobronchial squamous carcinomas highlights a localized bronchial thickening with a long outgrowth, plated on the wall of the bronchus for about 5 cm [19]. Central mass lesions may show either sheath or occlusion of the segmental or lobar bronchus/endobronchial component or sheath of adjacent vessels [40]. As a distinct sign of endobronchial tumors, we frequently encounter "the sign of the bronchus" [20]. ...
... CT scans have highlighted the characteristic signs of endobronchial tumors, with different degrees of obstruction of the bronchial tree, the bronchus sign, and the cutoff sign, with the prominence of the endobronchial tumor formation [5,9,19,20,[38][39][40]. On closer examination, there are signs of localized thickening of the bronchial wall in squamous cell carcinoma [19], but it is not mentioned in the literature as a specific feature. ...
Background: Endobronchial squamous cell carcinoma is one of the most common types of tumors located inside the tracheobronchial tree. Patients often present in advanced stages of the disease, which most often leads to a targeted therapeutic attitude of pneumonectomy. Practicing lung parenchyma-preserving surgery led us to undertake this review. Materials and methods: We used three search platforms—SCIENCE, MEDLINE, and PubMed—in order to identify studies presenting case reports, investigations, and reviews on endobronchial squamous cell carcinoma. We identified the clinical and paraclinical features of endobronchial squamous cell carcinoma. All the selected articles were in English and addressed the clinical criteria of endobronchial squamous cell carcinoma, autofluorescence bronchoscopy in endobronchial squamous cell carcinoma, imaging features of endobronchial squamous cell carcinoma, blood tumor markers specific to lung squamous cell carcinoma, and histopathological features of endobronchial squamous cell carcinoma. Results: In total, 73 articles were analyzed, from which 48 articles were selected as bibliographic references. We present the criteria used for the identification of endobronchial squamous cell carcinoma in order to highlight its main characteristics and the most reliable technologies that can be used for the detection of this type of cancer. Conclusions: The current literature review highlights the clinical and paraclinical characteristics of endobronchial squamous cell carcinoma. It aims to open new paths for research and early detection with respect to the frequent practice of lung parenchymal preservation surgery.
