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Lung cancer
Definition
Lung cancer, the leading cause of cancer death in the United States, occurs when certain cells within the lungs grow in an uncontrolled,
abnormal manner. According to the American Cancer Society, in 2011, more than 221,000 patients were diagnosed with lung cancer
and nearly 157,000 have died from the disease (American Cancer Society, 2011).
The primary types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Solitary pulmonary
nodule, or SPNs, which are defined as a discrete, well-marginated, rounded opacity less than or equal to three cm in diameter, may be
benign or malignant. PET helps with this characterization and helps avoid many unnecessary lung biopsies (Asif Alavi & Chief Editor:
Zab Mosenifar, 2009).
Role of molecular imaging
Molecular imaging is involved in multiple facets of the NSCLC through detection, diagnosis and treatment of NSCLC, which accounts
for the majority of lung cancer cases. Treatment options for NSCLC include chemotherapy and radiation, and if diagnosed early
enough, surgery. Accurate assessment and confirmation of metastasis is vital for determining the appropriate treatment option. For
those patients with painful bone metastases, there are two radiopharmaceutical agents which can help provide relief from pain.
Many patients with SPN are symptomless, but disease may be detected through chest x-ray. It is critical to determine whether an SPN
is malignant as it is a common abnormality seen on chest x-rays. PET/CT is a good scan to use in SPNs.
Positron emission tomography (PET) is used for lung cancer in a variety of ways:
 Assist in determining whether a suspicious SPN is malignant or benign and assist in determining the appropriate site for
biopsy
 Help identify whether cancer has spread to the lymph node or the bones
 Assist the physician in determining how well the cancer is responding to therapy
 Help distinguish between the effects of radiation therapy from recurrent disease
 For lung cancer that has spread to the bones, PET and nuclear medicine bone scans can evaluate the extent of the disease
Trade names
Approved indications in adults
(pediatric use as noted)
Radiopharmaceutical
Manufacturer
Fluorine-18
fluorodeoxyglucose
Various
As a PET imaging agent to:
 Assess abnormal glucose metabolism
Fluorine-18 sodium fluoride
Various
PET bone imaging agent to delineate areas of
altered osteogenesis activity
Samarium-153 lexidronam
EUSA Pharma
Strontium-89 chloride
Bio-Nucleonics
GE Healthcare
Quadramet®
Metastron
TM
Indicated for relief of pain in patients with
confirmed osteoblastic metastatic bone lesions
that enhance on radionuclide bone scan
Indicated for the relief of bone pain in patients
with painful skeletal metastases that have been
confirmed prior to therapy
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CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their
respective owners.
.
Radiopharmaceutical
Manufacturer
Trade names
Technetium-99m Medronate
Bracco Diagnostics
DRAXIMAGE
DRAXIMAGE
GE Healthcare
Pharmalucence
MDP-Bracco
MDP
MDP Multidose
Technetium-99m Oxidronate
Covidien
Technescan HDP
Technetium-99m
Pyrophosphate
Covidien
Pharmalucence
Technescan PYP™
Approved indications in adults
(pediatric use as noted)
TM
As a bone imaging agent to delineate areas of
altered osteogenesis
TM
As a bone imaging agent to delineate areas of
altered osteogenesis (adult and pediatric use)
TM
As a bone imaging agent to delineate areas of
altered osteogenesis
MSDS and package insert information
© 2015 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO
CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their
respective owners.
.