positron emission tomography (PET) may signal new, unrelated malignancies,
according to a study appearing in the February issue of the journal
Radiology. "The unexpected abnormalities we followed up on were significant,"
said the study`s lead author, Harry Agress Jr., M.D., who is director of nuclear
medicine at Hackensack University Medical Center`s PET center.
"Approximately 71% of the lesions that were confirmed with biopsy were
either malignant or premalignant. Typically, these cancers were not
symptomatic and were unrelated to the primary cancer for which the scan was
performed."
The researchers evaluated 1,750 PET scans of known or suspected cancers
to determine the importance and malignant potential of additional, unexpected
abnormal findings encountered during routine PET evaluation. They identified
58 abnormalities in 53 patients. Most abnormalities were found in the colon,
while others were located in the breast, fallopian tube, uterus, gallbladder,
larynx, ovary, bone and thyroid.
45 abnormalities were further evaluated with additional computed
tomography (CT), magnetic resonance imaging and/or mammography, and 42
were subsequently biopsied. Thirty (71%) of the biopsied abnormalities were
either malignant or premalignant tumors that were unrelated to the primary
tumor already under study.
Follow-up is crucial when the PET evaluation reveals incidental findings. "If
we had not pursued the abnormalities disclosed by PET, these patients would
only have been treated for their known cancer while another malignancy
remained undiagnosed." Dr. Agress said. "Patients reported no symptoms in
92% of the incidental findings that we confirmed, and the other 8 percent
were symptomatic only in retrospect or had been unsuccessfully worked up for
symptoms prior to the PET scan."
For instance, in one patient with a lung nodule that was proven benign, an
incidental PET abnormality was noted in the breast. In a follow-up
mammogram and ultrasound with specific attention to the area of PET
abnormality, a subtle cancer was identified and proven by biopsy.
■ 기사 요지
온라인 의약전문신문 `atmedica`에 게재된 내용으로, 최근 새로운 암진단장비로 각광받고
있는 양전자방출단층촬영술(PET)의 임상효과를 다루고 있다.
미국 하켄섹의대 핵의학과 헤리 어그레스 교수팀이 이미 암진단을 받은 환자들을 대상으로
PET 촬영을 실시한 결과, 기존방식의 촬영술에서 발견되지 않았던 미세한 종양을 찾아낼 수
있었다. 1750여회의 PET 스캔을 검토한 결과, 53명의 환자에서 58개의 새로운 종양이 확인
됐다. 확인된 종양샘플을 분석한 결과, 악성이거나 전암단계의 종양인 것으로 밝혀졌다.
정리·이상돈 기자
sdlee@kimsonline.co.kr