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D.S. Moraitis
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-031 - Usefullness of Positron Emission Tomography in Thymic Lesions' Surgery (ID 2368)
09:30 - 09:30 | Author(s): D.S. Moraitis
- Abstract
Background:
To evaluate the utilization of positron emission tomography (PET) scan with fluorine-18 fluorodeoxyglucose (FDG) in the selection of the surgical approach for thymic lesions.
Methods:
Twenty-two consecutive patients with thymic pathology, underwent PET-FDG after being evaluated by computed tomography (CT), since 2011. The Standard Uptake Value (SUV) max of the lesion, as well as the SUV of the mediastinum, were estimated. The ratio SUVmax Lesion/Mediastinum was the caliber for selecting thoracoscopic thymectomy (TT) or thymectomy via median sternotomy (TMS), as the therapeutic procedure. If the ratio SUVmax L/M < 1, thoracocscopic thymectomy was preferable. If the ratio was, 1 < SUVmax L/M < 2, the selection was depended on the lesion’s dimensions (TT was preferred for lesions < 4 cm). If the ratio was SUVmax L/M > 2, a median sternotomy was the approach of choice.
Results:
There were 14 male and 8 female patients, with a mean age of 41.1 y.o. In 13 patients the ratio SUVmax L/M showed up > 1, while in 4 patients was higher than 2. The histopathology revealed 7 thymomas, 2 thymolipomas, 8 true thymic hyperplasias, 1 non seminomatous tumour, 1 silicone indused lemphadenopathy while 1 patient is waiting for TT and another one (type C thymoma by fine needle biopsy), for TMS. The mean SUVmax for thymomas was 3.02+-1.67, for thymolipomas was 1.48+-0.26, for true thymic hyperplasias was 1.82+-0.42, while the non seminomatous’ tumour SUVmax was 12.4. There have been performed 7 TTs, 1 Transcervical approach and 13 TMSs. R0 resection was achieved in all 21 patients, have undergone operation, so far. All patients had an uneventful postoperative course and the mean duration of hospital stay was 4 days for TTs and 7 days for TMSs.
Conclusion:
There is no imaging modality sufficient by itself to identify the nature of thymic lesions. The intensity of FDG uptake is useful for predicting the grade of malignancy, and high FDG uptake may reflect the invasiveness of the malignant nature in thymic epithelial tumors. The creation of a scale of “metabolic biopsy” with the use of the ratio SUVmax L/M, will allow the use of TT to a larger patient population, following of course, the surgical oncology guidelines for the removal of thymic lesions.
