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Lung Pet Scan
One of the most important uses of Positron Emission Tomography (PET) technology
is its use in diagnosing and treating lung cancer. Lung cancer is the leading
cause of cancer death in both men and women. The American Cancer Association
estimates that 173,770 new cases of lung cancer will be diagnosed in 2004. Additionally,
the American Cancer Association estimates that lung cancer deaths will reach
a level of 160,400, which will account for approximately 28% of all cancer deaths
in 2004.
About Lung Cancer
Lung cancer is the leading cause of cancer death and it is estimated that during
their lifetime, 1 in 21 women will develop lung cancer and 1 in 11 men will
develop this disease. Lung cancer occurs when lung cells become abnormal and
form more cells in an uncontrolled manner. A tumor, which is a mass of tissue,
develops out of these extra cells and can either be benign (non-cancerous) or
malignant (cancerous). Although, there are a variety of types of lung cancer,
this disease can be classified in two groups:
- Small cell lung cancer (SCLC):
C cancer cells are small but quickly form large tumors that can progress to
other parts of the body such as the lymph nodes, brain, liver, and bones.
Also known as oat cell cancer, SCLC accounts for approximately 20% of all
lung cell cancers.
- Non-small cell lung cancer (NSCLC):
The most common form of lung cancer that incorporates a variety of cancer
sub-types such as Squamous cell carcinoma, adenocarcinoma, and large cell
carcinoma. This type of cancer also spreads to other parts of the body but
tends to progress slowly to different parts of the body slower than SCLC.
The principal cause of lung cancer is cigarette smoking. Before cigarette smoking
became popular in the early 20th century, lung cancer was a rare occurrence.
However, cases of lung cancer have exploded over the last century with an estimated
87% of lung cancer cases stemming from smoking. Cigarette smoke contains over
4,000 different chemicals and many of these cancers have been proven to be carcinogens
(cancer-causing substances). The probability of lung cancer increases with the
amount of time and quantity an individual smokes. Additionally, the use of smokeless
tobacco products and the smoking of other forms of tobacco products are major
causes of lung cancer.
Another major cause of lung cancer is second-hand smoke, which is a byproduct
of smoking. Chemicals present in tobacco smoke affect nonsmokers who are inhaling
the smoke, and second hand smoke has been identified as causing approximately
3,000 lung cancer deaths per year. Second hand smoke has also been identified
as causing approximately 50,000 deaths from heart disease per year.
The second biggest cause of lung cancer is exposure to radon: an invisible,
odorless, and radioactive gas. Radon gas is commonly found in mines as well
as in the home. It often emerges from soil underneath a building that enters
through gaps and cracks in a building’s foundation or insulation. Radon can
also enter a home through other openings such as pipes, drains, and walls. Currently,
it is estimated that radon exposure makes up 12% of all lung cancer deaths,
causing between 15,000 and 22,000 lung cancer deaths per year.
An additional cause of lung cancer is on-the-job exposure to carcinogens. The
most common carcinogen is asbestos, (a substance commonly used in shipbuilding,
insulation work, and brake repair) which if inhaled can cause cell damage that
increases the potential of lung cancer. Additional carcinogens that are often
found on work sites include: uranium, arsenic, and certain petroleum products.
Symptoms of Lung Cancer
Regardless of the type of lung cancer, the PET scan is an important tool that
can be used to reverse its effects. Often described as a silent killer, lung
cancer is a difficult disease to diagnose while in its early stages, as it does
not contain any symptoms. Although lung cancer is a disease that takes many
years to develop, exposure to carcinogens produce immediate changes to the lung.
Following exposure to carcinogens, a few abnormal cells may appear in the lining
of the bronchi, which are the main breathing tubes. If a person is continually
exposed to carcinogens, the number of abnormal cells will increase and these
cells will progressively become malignant and thus more cancerous. These abnormal
cells may eventually form a tumor. However, if a person avoids exposure to carcinogens,
normal cells will replace these abnormal cells and the risk of lung cancer will
drastically reduce.
As lung cancer takes many years to develop and do not produce symptoms in its
early stages, most cases of lung cancer are diagnosed when a patient is between
55 to 65 years old. By that point, the lung cancer has progressed to the point
that cancerous cells have broken away and spread to other parts of the body.
Consequently, the overall five-year survival rate for these patients is less
than 10%. However, if lung cancer is found in its early stage where the cancerous
have yet to spread to other organs, the overall five-year survival rate improves
to 35% to 45%. Approximately 15% of lung cancers are found in this early stage
although lung cancer continues to be a difficult disease to notice.
Although lung cancer symptoms are vague, you may want to visit a doctor if
you are experience these phenomena:
- The presence of a chronic cough that doesn’t go away or worsens
- Instances of coughing up blood
- The presence of constant chest pain
- The condition of wheezing, hoarseness, or general shortness of breath
- Repeated problems with pneumonia or bronchitis
- Instances of neck and facial swelling
- Appetite loss or weight loss
- A feeling of general fatigue
- The presence of a fever without a known reason.
PET and Lung Cancer Diagnosis
Positron Emission Tomography is an effective procedure used in the diagnosis
and treatment of lung cancer in the various medical stages of treatment. PET
scans for lungs are one of the most effective imaging tools in diagnosing lung
cancer. As lung cancer has very little symptoms in its early stages, it is usually
detected through an anatomical imaging procedure such as chest x-rays or a computerized
tomography scan that was performed for another medical reason. Although these
anatomical imaging techniques are useful in detecting the size and location
of a lung mass that can be indicative of a cancerous tumor, a lung cancer PET
scan will be able to detect whether or not this abnormality is benign (alive
tissue and non-cancerous) or malignant (dead tissue and cancerous).
PET imaging is able to detect cancerous cells, as it is a metabolic imaging
tool. With PET scans, the chemical function of the lung and other targeted organs
or tissues are examined. PET images are able to visualize biochemical changes
caused by disease. This function differentiates the PET from such anatomic imaging
tools as x-rays, computed tomagraphy (CT), and magnetic resonance imaging (MRI),
as these tools are only able to produce images detailing body structure.
PET scans involve the administering of a radioactive tracer that is a combination
of a radioisotope (a radioactive compound whose movements are detectable by
a PET scanner) with a natural body compound. In lung cancer diagnosis, the radioactive
tracer used in the Positron Emission Tomography procedure is Fluorodeoxyglucose
(FDG), which combines the natural body compound glucose with the radioisotope
Fluorine-18. This radioactive tracer, or radiopharmaceutical, is used in lung
cancer detection as the radioactive compound that it uses has a short half-life
and will disappear from the body within hours. Therefore, PET scan for lungs
are safe and the patient should free themselves of any worry about the radiation
content of this procedure.
Additionally, lung cancer PET scan uses FDG as it contains the body compound
glucose. The use of FDG, which shares a similar structure to glucose, is important,
as the absorption of glucose is effective in determining whether a cell is healthy
or cancerous. PET imaging traces the absorption rate of FDG by cells and can
determine whether cancerous cells are present in the lung and other organs or
tissues, as glucose (which FDG shares a similar structure) is absorbed at a
faster rate by cancerous cells compared to healthy cells. By tracing the movement
of FDG in a patient’s organ, the physician is able to determine whether the
lung mass detected through anatomic imaging is benign (non-cancerous) or malignant
(cancerous). From the images produced by the PET scan, a physician will be able
to make an informed diagnosis, as these images are able to show whether the
lung is normal and healthy or if there is the presence of lung cancer. This
will reduce the number of unnecessary surgeries performed on patients who have
tumors present in their body, but whose tumors are actually benign and therefore
not indicative of cancer.
In this way, the PET scan is able to provide the same information (in a non-invasive
manner) that a biopsy would, which often involves the insertion of a bronchoscope
(a small tube) through the patient’s nose or mouth that goes down the patient’s
throat that takes a sample, or biopsy, of the tumor from the patient’s airways
and lungs.
PET and Lung Cancer Staging
Besides detection, PET scans are effective in the treatment of lung cancer
when it is used during the staging phases. Staging commences following lung
cancer diagnosis and is used to determine if or how much the lung cancer has
spread or metastasize. PET scan lung metastasis is an important component of
the staging phase of lung cancer treatment is critical as it provides the necessary
information for physicians in determining an appropriate medical course of lung
cancer treatment.
Through PET imaging, a physician is able to determine whether or not cancerous
cells have spread from the lungs to other parts of the body. Positron Emission
Tomography involves the administration of a radioactive tracer that combines
a radioisotope, a radioactive compound that is detected by a PET scanner, with
a natural body compound, which the body is able to integrate into its system
without any negative effects. In lung cancer screening, the radioactive tracer
used is Fluorodeoxyglucose (FDG) that combines the natural body compound glucose
with the radioisotope Fluorine-18. Although many patients have concerns about
the radioactive component contained in PET imaging, Fluorine-18 contains a short
half-life and disappears from the body within hours. Consequently, the PET procedure
is a safe one for patients.
In the staging process, PET scans are the most effective imaging tool in determining
the spread of cancerous cells. Other imaging tools such as computerized tomography
(CT), magnetic resonance imaging (MRI), and x-rays are able to determine the
possibility of cancer spread by examining changes in the anatomical structure
of organs and tissues. Lung cancer mainly spreads to the brain, bone, and liver,
although it can spread to nearly anywhere in the body.
These imaging tools then detect cancer spread by examining other body organs
for anatomical changes. Consequently, these anatomic imaging tools detect cancer
spread by identifying instances where organs or tissues have shown increased
mass sizes.
However, PET determines cancer spread more comprehensively than these other
imaging tools, as it detects biochemistry changes among these organs and tissues.
By tracing the spread of FDG in a patient’s body, PET imaging is able to establish
patterns of cancer spread based on the body’s chemical reactions to FDG. As
it is similar in structure to glucose, PET determines cancer spread by studying
the absorption of FDG by the patient’s organs and tissues. FDG is absorbed at
a faster rate by cancerous organs and tissues than healthy organs and tissues.
By studying the biochemical reaction of the patient’s body, PET scan is able
to produce the most accurate analysis of whether lung cancer has spread to other
areas of the body.
This information is critical in determining an accurate outlook of patient
recovery. For example, through a PET scan, a physician is able to view whether
cancerous cells have spread to lymph nodes or other organs. If this is not the
case and surgery has been undertaken, the five-year survival rate of this surgery
will increase to approximately 42%. PET imaging contains an 82% accuracy rating
in determining whether lung cancer has spread to the lymph nodes compared to
the 68% accuracy rating of CT scanning. Consequently, PET imaging is the most
accurate staging diagnostic imaging tool that will aid a physician’s decision
in recommending the appropriate treatment option.
In cases where PET imaging has shown that cancerous tumors are located in an
appropriate location within the lung, surgery is often the best option. Surgery
can cure lung cancer but its use depends on such variables as its location in
the lung and also its size. Other medical treatments to lung cancer include:
radiation therapy, which is a high energy X-ray that kills cancer cells; and
chemotherapy, which uses drugs to effectively treat lung cancer.
The medical course of action used to treat lung cancer is often determined
by staging. Staging is a vital step in the patient’s road to health recovery,
as all of these treatment options are contingent on the size of the cancerous
tumor, the spread of cancerous cells, and the location of the cancerous tumor.
A PET scan is the most effective lung cancer staging tool and is a vital tool
used by physicians in providing a specialized, medical plan to eradicate lung
cancer from the patient.
PET and Lung Cancer Follow-Up
Another valuable function of Positron Emission Tomography in lung cancer treatment
is its role in studying the patient’s recovery. Following staging, a physician
will recommend a medical course of action that they feel are the most appropriate
and effective. In most instances, chemotherapy, radiation therapy, or a combination
of both is used to treat lung cancer. Although these treatments are usually
effective, an important component of lung cancer treatment is determining whether
active cancer cells have remained in the body following treatment.
Prior to the clinical use of PET scan, physicians applied radiation therapy
and chemotherapy according to standard rules. However, with PET imaging, it
is now possible for physicians to specifically cater lung cancer treatment to
your particular situation. This is because Positron Emission Tomography allows
a physician to view the location, extent, and resilience of a patient’s lung
cancer.
Additionally, PET imaging is the most effective diagnostic tool in detecting
lung tumor response to therapy. PET scans study the chemical function of the
lung and other organs and tissues and is able to produce images that show visual
biochemical changes in the body caused by lung cancer. Unlike such anatomic
imaging tools as x-rays, computed tomagraphy (CT), and magnetic resonance imaging
(MRI) that detail changes in body structure such as the presence of tumors,
PET imaging is able to determine whether a tumor is benign (alive tissue and
non-cancerous) or malignant (dead tissue and cancerous). Therefore, a PET scan
lung metastasis is an important method used by physicians to examine recurrence
of cancer in the patient.
PET scans involve the administration of the radioactive tracer, Fluorodeoxyglucose
(FDG) that combines the natural body compound glucose with the radioisotope
Fluorine-18. FDG safely travels through the body where a PET scanner monitors
its movement within the body. A radioactive tracer that disappears from the
body within hours, FDG is able to detect cancer recurrence in successfully treated
lesions as well as determine whether tumors identified in an anatomic imaging
scan are cancerous or not.
This is because FDG is similar in structure to glucose, which cancerous cells
absorb at a faster rate than healthy cells. By tracing the absorption rates
of FDG by the targeted cells, a physician is able to determine whether successfully
treated lesions are showing signs of cancer recurrence. Additionally, PET imaging
is able to detect cancer recurrence in lymph nodes and/or scar tissue from surgery
from surgery or another lesion sooner than an anatomical imaging procedure.
PET scans are also able to distinguish between cancerous and non-cancerous tumors
that are detected by anatomical imaging and are still present despite lung cancer
treatment.
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