Journal of Jilin University Medicine Edition ›› 2015, Vol. 41 ›› Issue (06): 1275-1278.doi: 10.13481/j.1671-587x.20150634

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Application of 18FDG PET/CT in diagnosis of ectopic ACTH syndrome induced by lung cancer

CHENG Xin, MA Yanru, LIU Yimin, DANG Yonghong, XING Haiqun, HU Nan   

  1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2015-08-03 Published:2016-01-11

Abstract:

Objective To investigate the value of 18F-fluorodeoxyglucose(18FDG) positron emission tomography and computer tomography(PET/CT) in the diagnosis and localization of ectopic ACTH syndrome(EAS) induced by lung cancer, and to increase the accuracy rate of diagnosis of EAS. Methods 8 patients were histopathologically proven to be lung cancer. 18FDG PET/CT wholebody and brain scan were performed; magnetic resonance imaging(MRI), 99mTc-octreotide(OCT) imaging and inferior petrosal sinus sampling(IPSS) were done in all patients. On 18FDG PET/CT images, the SUVmax values of lesions and the SUVmax ratio of lesion tissue to normal lung tissue were calculated. Results ① 8 patients with EAS included 2 cases of carciniod, 4 cases of atypical carciniod, and 2 cases of small cell lung cancer. The ACTH levels in inferior petrosal sinus and peripheral veins of 8 patients had no difference.②The chest CT showed there were pulmonary nodules in 6 cases (75%), among them 2 cases were atypical lesions. 5 cases of pituitary adenomas were found by MRI(25%), and OCT imaging was positive in 2 cases (25%).③ The 18FDG PET/CT showed nodular, mass like or patch samples with high metabolic activity in 8 cases (100%) of pulmonary lesions. The SUVmax of tumor was 0.72 to 14.05 (3.67±4.68), and the ratio of SUVmax of lesion tissue to normal lung tissue was 1.69 to 27.54 (8.14± 9.63). 18FDG hypermetabolism was found in 8 cases of bilateral adrenal hyperplasia, while 4 cases showed pituitary tumor. Conclusion Lung cancer is a common source of EAS, especially carcinoid. 18FDG PET may show lower glucose metabolism. 18FDG PET/CT should be used as an assisted method to diagnose EAS.

Key words: lung neoplasms, pulmonary carcinoid, Cushing syndrome, ectopic adrenocorticotrophic hormone syndrome, positron emission tomography, 18F-fluorodeoxyglucose

CLC Number: 

  • R445.5