Added Value of PET/CT in Lung Cancer
- Conditions
- Lung Cancer
- Interventions
- Diagnostic Test: True cut needle biobsy
- Registration Number
- NCT06494800
- Lead Sponsor
- Sohag University
- Brief Summary
Assess the value of PET/CT in the diagnosis, staging, response evaluation, and relapse monitoring of lung cancer.
- Detailed Description
Lung cancer is a leading cause of cancer-related mortality worldwide, accounted for 1.80 million deaths in 2020.(1)Egyptian statistics showed that lung cancer in men represents 8.2% of among all cancers of men according to the Egyptian National Cancer Program in 2014 (3).Epidemiological data indicate that the main risk factor for the development of lung cancer is cigarette smoking.(4)Lung cancer is histologically divided into: Non-small-cell lung cancer (NSCLC), which accounts for 85% of cases and Small cell lung cancer (SCLC).(5)Due to absence of screening, most patients with lung cancer are not diagnosed until later stages, when the prognosis is poor.(6)Radiologic manifestations of bronchogenic carcinoma include obstructive pneumonitis or atelectasis, lung nodule or mass, apical mass, cavitated mass, or nodule or mass associated with lymphadenopathy(6)Conventional chest radiography, computed tomography (CT), magnetic resonance imaging, radionuclide scintigraphy, and positron emission tomography (PET) all have been used for NSCLC staging.(7)PET/CT is a well-established radiological modality with high diagnostic accuracy in metastases detection compared to usual CT. Also, it has been reported that up to 10% of patients with bronchogenic carcinoma are found to have metastases on PET/CT that were not detected on CT with subsequent different patients' staging. The high accuracy of PET/CT in tumor staging makes it important for the treatment strategy of either surgical treatment, radiotherapy, or chemotherapy. Also, it becomes essential during the follow-up to detect recurrence. PET/CT shows a higher ability to evaluate the early response to the treatment as chemotherapy by its ability to detect the metabolic response even before the size change.(8)The prognosis of lung tumors depends on early and accurate staging as well as the histopathological type of the primary tumor, with the squamous cell carcinoma type regarded to be of a worse prognosis than that of adenocarcinoma.(9)
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 30
- Pathologically proven lung cancer patients.
- Patients with second malignancy.
- Severely ill patient (patient with disturbed consciousness level, or couldn't lie during the imaging).
- Uncontrolled diabetic patient with blood glucose level more than 200mg\dl.
- Pregnant women.
- Patient age <18 years.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description pathologically proved lung cancer patient True cut needle biobsy All the pathologically proved lung cancer patients by true cut needle biobsy are enrolled in the study. the true cute needle biobsy procedure performed by two interventional radiologists and a pathologist. TCNB was guided by the use of a 16-detector CT device after local anesthesia is done and done either by ultrasound guidance or CT guidance.
- Primary Outcome Measures
Name Time Method Value of PET CT in staging of lung cancer 1 Year using the PET CT in TNM staging with better detection of pleural , mediastinal extension /involvement, the value and accuracy of PET in detecting the potential malignancy of the mediastinal lymph nodes even the subcentemetric lymph nodes not adequately assessed by the usual CT.
Differentiating between the primary mass and associated consolidation if present 1 Year using the PET CT (mainly the qualitative assessment) in differentiating the primary mass from the associated consolidation-atelectasis around
Accuracy of PET CT in diagnosis of lung cancer 1 Year using the qualitative and quantitative measuring including the SUV max value in detection of the malignant potentiality of the pulmonary nodule or mass comparing it with the pathological result
predicting the pathological subtype of lung cancer using the morphological and PET CT of pathologically proved lung masses 1 Year assessing the morphology of the lung mass including density, solid, subsolid and soft nodule.
site of the nodule/mass peripheral or centrally located. presence of cavitation or cystic changes. presence of speculated or irregular margin. measuring the SUV max and comparing it with the pathology of each mass/nodule.
- Secondary Outcome Measures
Name Time Method assessing the Vocal cord paralysis in the pan-coast tumor 1 Year using the morphological assessment of the lower CT neck scans and the adduction of the vocal cord and the atrophic changes of the Muscle and loss of vocal cord physiological activity.
presence of enlarged axillary Lns 1 Year assessing the activity of enlarged axillary Lns by measuring the SUV value
assessment of the pleural thickening/effusion associated with the primary mass 1 Year assessing the qualitative and quantitative assessing the pleural thickening if found for differentiating the pleural involvement from the inflammatory pleural thickening