Toraks Nüklear Tıp Değerlendirmesi
Özet
F-18 Florodeoksiglukoz (FDG) Pozitron Emisyon Tomografisi / Bilgisayarlı Tomografi (PET/BT), toraks bölgesindeki malignitelerin fonksiyonel ve metabolik olarak değerlendirilmesinde yaygın kullanılan bir nükleer tıp yöntemidir. Onkolojik süreçlerde hücrelerin artan glukoz metabolizmasından faydalanarak malign-benign dokuların ayrımını, tümörün evrelenmesini (TNM), radyoterapi planlamasını ve tedaviye yanıtın moleküler düzeyde izlenmesini sağlar. Soliter pulmoner nodüllerin (SPN) karakterizasyonunda kılavuzlar doğrultusunda tamamlayıcı rol oynarken, inflamatuar durumlar ve küçük lezyonların uzaysal çözünürlük limitleri yanlış sonuçlara yol açabilir. Küçük hücreli dışı (KHDAK) ve küçük hücreli akciğer kanserlerinde (KHAK) lenf nodu tutulumu ve beyin dışı uzak metastazların tespitinde yüksek doğruluk sunar. Ayrıca malign plevral mezotelyoma ile timoma, lenfoma, germ hücreli, trakeobronşiyal, özofagus ve kardiyak gibi mediastinal kitlelerin ayırıcı tanısında, takibinde ve SUVmax, MTV, TLG gibi kantitatif parametrelerle prognoz tayininde kritik öneme sahiptir.
F-18 Fluorodeoxyglucose (FDG) Positron Emission Tomography / Computed Tomography (PET/CT) is a widely used nuclear medicine method for the functional and metabolic evaluation of thoracic malignancies. By leveraging the increased glucose metabolism of cells in oncological processes, it enables the differentiation of malignant-benign tissues, tumor staging (TNM), radiotherapy planning, and monitoring of treatment response at the molecular level. While playing a complementary role in characterizing solitary pulmonary nodules (SPN) per guidelines, inflammatory conditions and the spatial resolution limits of small lesions can cause false results. It offers high accuracy in detecting lymph node involvement and extra-cranial distant metastases in non-small cell (NSCLC) and small cell lung cancers (SCLC). Furthermore, it is critical in the differential diagnosis, surveillance, and prognostic evaluation—via quantitative parameters like SUVmax, MTV, and TLG—of malignant pleural mesothelioma and mediastinal masses including thymoma, lymphoma, germ cell, tracheobronchial, esophageal, and cardiac tumors.
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