Pancoast tumor other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overveiw

Other diagnostic studies for evaluating the spread of Pancoast tumor include bone scintigraphy, PET scan, and molecular tests.

Other Diagnostic Studies

Other diagnostic studies for evaluating the spread of Pancoast tumor include bone scintigraphy, PET scan, molecular tests, biopsy.

Bone Scintigraphy

A bone scan may demonstrate bone metastases.

PET scan

FDG(18 F fluoro deoxyglucose) PET scans along with contrast enhanced CT may be helpful in the diagnosis of extent of lung cancer. Findings on FDGPET/CT suggestive of lung cancer include:^[1]
- Solitary pulmonary nodule
Benefits of FDGPET/CT include:^[2]
- Accurate delineation of the viable tumor from surrounding atelectasis and collapse or consolidation.
- It may further lead to a change in staging and treatment options of the lung cancer.
- Provide guidance for the biopsy.^[3]

Role of FDG PET/CT in primary tumor delineation. Irregular soft tissue opacity seen on coronal CT scan (arrow, A) with no obvious demarcation between the tumor and surrounding consolidation. PET/CT shows the FDG-avid tumor (arrow, B) separate from the non–FDG-avid consolidation (arrowhead, B),via <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419420/figure/F6/>^[1]

Molecular Test

Molecular tests include epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) mutation. Specific targeted agents may be administered to patients if these mutations are present. A transthoracic needle biopsy and a bronchoscopy are conducted to diagnose lung cancer.

Biopsy

A transthoracic needle biopsy, guided by CT or fluoroscopy, is for pancoast tumors located in the periphery of the lungs since peripheral tumors are not accessible through a bronchoscope.

References

↑ ^1.0 ^1.1 Purandare, NilenduC; Rangarajan, Venkatesh (2015). "Imaging of lung cancer: Implications on staging and management". Indian Journal of Radiology and Imaging. 25 (2): 109. doi:10.4103/0971-3026.155831. ISSN 0971-3026.
↑ van Baardwijk, Angela; Baumert, Brigitta G.; Bosmans, Geert; van Kroonenburgh, Marinus; Stroobants, Sigrid; Gregoire, Vincent; Lambin, Philippe; De Ruysscher, Dirk (2006). "The current status of FDG–PET in tumour volume definition in radiotherapy treatment planning". Cancer Treatment Reviews. 32 (4): 245–260. doi:10.1016/j.ctrv.2006.02.002. ISSN 0305-7372.
↑ Purandare, Nilendu C.; Kulkarni, Aniruddha V.; Kulkarni, Suyash S.; Roy, Diptiman; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh (2013). "18F-FDG PET/CT-directed biopsy". Nuclear Medicine Communications. 34 (3): 203–210. doi:10.1097/MNM.0b013e32835c5a57. ISSN 0143-3636.

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[PurandareRangarajan2015-1] 1.0 ^1.1 Purandare, NilenduC; Rangarajan, Venkatesh (2015). "Imaging of lung cancer: Implications on staging and management". Indian Journal of Radiology and Imaging. 25 (2): 109. doi:10.4103/0971-3026.155831. ISSN 0971-3026.

[van_BaardwijkBaumert2006-2] van Baardwijk, Angela; Baumert, Brigitta G.; Bosmans, Geert; van Kroonenburgh, Marinus; Stroobants, Sigrid; Gregoire, Vincent; Lambin, Philippe; De Ruysscher, Dirk (2006). "The current status of FDG–PET in tumour volume definition in radiotherapy treatment planning". Cancer Treatment Reviews. 32 (4): 245–260. doi:10.1016/j.ctrv.2006.02.002. ISSN 0305-7372.

[PurandareKulkarni2013-3] Purandare, Nilendu C.; Kulkarni, Aniruddha V.; Kulkarni, Suyash S.; Roy, Diptiman; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh (2013). "18F-FDG PET/CT-directed biopsy". Nuclear Medicine Communications. 34 (3): 203–210. doi:10.1097/MNM.0b013e32835c5a57. ISSN 0143-3636.

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