Frequency of Incidental Pulmonary Findings Detected on PET/CT Images of Elderly Patients Diagnosed with Extrapulmonary Malignant Neoplasm

INTRODUCTION: Reporting thorax imaging findings on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is important for patient management. Even if some pulmonary findings are benign, they can have serious life-threatening consequences. This study aimed to investigate the frequency of benign or malignant pulmonary findings, which were simultaneously detected in PET/CT scans, of elderly patients with extrapulmonary malignant neoplasms.
METHODS: Patients aged ≥65 years, applying to nuclear medicine department of a tertiary level health unit between November 2017 and April 2018 were retrospectively evaluated. Demographic and clinical information and PET/CT scans were obtained from their previous hospital records. Data obtained were analyzed using the SPSS version 22.
RESULTS: A total of 112 patients (mean age, 72.8 ± 7.0; females, 58.9%) were included in the study. In total, 38.4% of the patients had a smoking history, and 39.2% were exposed to second-hand smoke. The most common indications for PET/CT imaging were post-treatment evaluation (42.9%) and staging (35.7%). Predominantly diagnosed malignancies were cancers of the gastrointestinal system (26.8%), breast (26.8%), and urogenital system (17%). While most patients had benign or malign pulmonary findings in thoracic images, no abnormal pulmonary findings were observed in only 24 patients (21.4%). The most common findings were emphysema (39.3%), metastatic nodules (27.7%), bronchial wall calcifications (14.3%), and air trapping/cysts (9.8%).
DISCUSSION AND CONCLUSION: This study revealed that 78.6% of elderly patients with extrapulmonary malignant neoplasms undergoing PET/CT scans had at least one pathologic lung finding. Although most of these findings are benign, reporting of them is important in the management and clinical outcomes of patients with malignancy.

Ekstrapulmoner Malign Neoplazm Tanýlý Yaþlý Hastalarýn PET/BT Görüntülerinde Ýnsidental Pulmoner Bulgularýn Sýklýðý

GÝRÝÞ ve AMAÇ: 18F-fluorodeoksiglukoz (18F-FDG) pozitron emisyon tomografi-bilgisayarlý tomografide (PET/BT) malignite kuþkulu lezyonlara ilaveten, benign karakterdeki bulgularýn raporlanmasý da hasta yönetiminde önemlidir. Bazý pulmoner bulgular benign olsa bile hayati tehlike oluþturan ciddi sonuçlara yol açabilir. Bu çalýþmanýn amacý, ekstrapulmoner malign neoplazm tanýsý ile PET/BT çekilmiþ olan yaþlý hastalarda benign yada malign pulmoner bulgularýn sýklýðýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Üçüncü basamak saðlýk kuruluþu nükleer týp bölümüne Kasým 2017-Nisan 2018 tarihleri arasýnda baþvuran 65 yaþ ve üzeri hastalar retrospektif deðerlendirildi. Demografik verileri, klinik bilgileri ve PET/BT görüntüleri hastane kayýtlarýndan elde edildi. Bulgular SPSS 22 kullanýlarak analiz edildi.
BULGULAR: Toplam 112 hasta (yaþ ortalamasý 72.8±7.0; %58.9’ u kadýn olan) çalýþmaya dahil edildi. Hastalarýn %38.4’ ü aktif, %39.2’ si pasif sigara içicisiydi. En sýk PET/BT çekimi endikasyonu, tedavi sonrasý yanýt deðerlendirme (%42.9) ve evreleme (%35.7) idi. Tanýlarýn çoðunluðunu gastrointestinal sistem (%26.8), meme (%26.8) ve ürogenital sistem (%17) maligniteleri oluþturmaktaydý. Hastalarýn çoðunda toraks kesitlerinde benign yada malign pulmoner bulgulara rastlanýrken, sadece 24 hastada (%21.4) hiçbir anormal pulmoner bulgu izlenmedi. En sýk saptanan bulgular; amfizem (%39.3), metastatik nodül (%27.7), bronþ duvarý kalsifikasyonu (%14.3) ve hava hapsi/kisti (%9.8) idi.
TARTIÞMA ve SONUÇ: Bu çalýþma, ekstrapulmoner malign neoplazm tanýsý ile PET/BT çekilen yaþlý hastalarýn %78.6’ sýnda en az bir anormal pulmoner bulgunun olduðunu gösterdi. Bu bulgularýn çoðu iyi huylu olmakla birlikte, bunlarýn raporlanmasý malignitesi olan hastalarýn yönetimi ve klinik gidiþatýnda önemlidir.