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An assessment of 18F- FDG PET/CT for thoracic screening and risk stratification of pulmonary nodules in multiple endocrine neoplasia type 1

So, A, Pointon, O, Hodgson, R and Burgess, J 2018 , 'An assessment of 18F- FDG PET/CT for thoracic screening and risk stratification of pulmonary nodules in multiple endocrine neoplasia type 1' , Clinical Endocrinology , pp. 1-9 , doi: 10.1111/cen.13573.

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Abstract

Context: Bronchopulmonary neuroendocrine tumours (bpNETs) and thymic carci‐noid (ThC) are features of multiple endocrine neoplasia type 1 (MEN 1), and surveil‐lance guidelines recommend periodic thoracic imaging. The optimal thoracic imagingmodality and screening frequency remain uncertain as does the prognosis of smalllung nodules when identified.Objectives: To evaluate fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for identification and prognosticassessment of thoracic lesions in MEN 1.Design: Retrospective observational study.Setting and participants: Fifty consecutive MEN 1 patients undergoing screening with18F-FDG PET/CT at a tertiary referral hospital between July 2011 and December 2016.Interventions: 18F-FDG PET/CT.Outcome measures: Pulmonary and thymic lesion prevalence, size, functionalcharacteristics and behaviour.Results: Thirteen patients (26.0%) exhibited pulmonary nodules with multiple nod‐ules identified in nine (18.0%). An asymptomatic 31 mm FDG-avid ThC was identifiedin one patient (2%). Of the 13 patients with pulmonary nodules, four (8.0%) exhibited13 FDG-avid nodules (mean size 10.1 ± 9.1 mm), and nine (18.0%) demonstrated 26FDG nonavid nodules (mean size 6.9 ± 5.8 mm). All FDG-avid lesions increased in sizevs 11 (42.3%) FDG nonavid lesions (P = .0004). For FDG-avid and nonavid nodules,the median doubling time was 24.2 months (IQR 11.4-40.7) and 48.6 months (IQR37.0-72.2), respectively. Nodule resection was undertaken in two patients, typicalbronchial carcinoid diagnosed in one (FDG nonavid) and metastatic renal cell carci‐noma in the second (FDG avid).Conclusion: Thoracic imaging with 18F-FDG PET/CT effectively identifies pulmonarynodules and ThC. FDG-avid pulmonary lesions are significantly more likely toprogress than nonavid lesions.

Item Type: Article
Authors/Creators:So, A and Pointon, O and Hodgson, R and Burgess, J
Keywords: Bronchopulmonary Neuroendocrine tumour; Computed Tomography; Fluorodeoxyglucose (18F) positron emission tomography; Multiple Endocrine Neoplasia type 1 (MEN 1); Pulmonary Nodules; Thoracic Screening; Thymic Carcinoid
Journal or Publication Title: Clinical Endocrinology
Publisher: Blackwell Publishing Ltd
ISSN: 0300-0664
DOI / ID Number: 10.1111/cen.13573
Copyright Information:

© 2018 John Wiley & Sons Ltd

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