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2007, Número 4

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Cir Cir 2007; 75 (4)


Tomografía por emisión de positrones y tomografía computarizada (PET/CT) en carcinoma de pulmón

Altamirano-Ley J, Estrada-Sánchez GR, Ochoa-Carrillo FJ

Idioma: Español
Referencias bibliográficas: 50
Paginas: 303-311
Archivo PDF: 215.65 Kb.


RESUMEN

Introducción: El cáncer de pulmón es la causa más frecuente de muerte por neoplasia en el mundo occidental, con más de 660 mil nuevos diagnósticos al año, según la Organización Mundial de la Salud.
Objetivo: Dar a conocer a todos los profesionales de la salud relacionados con las neoplasias pulmonares, las indicaciones de la tomografía por emisión de positrones.
Discusión: Se han descrito falsos negativos con PET-18FDG en carcinoides y carcinoma bronquiolo alveolar hasta en 40 % de los casos. Una causa relativamente común de resultado falso positivo es la musculatura y las cuerdas vocales activas que captan 18FDG, como ocurre en la cuerda vocal del lado contralateral a la lesión pulmonar, por lesiones del nervio laríngeo recurrente por infiltración tumoral o lesión quirúrgica, lo cual no debe ser confundido con una zona de metástasis.
Conclusión: El PET/CT en pacientes con cáncer de pulmón resuelve los siguientes aspectos ante la sospecha de una lesión maligna: hacer el diagnóstico temprano (benignidad/malignidad del nódulo pulmonar solitario), localizar el sitio óptimo para la toma de biopsia, hacer el diagnóstico del tumor primario, estadificar inicialmente la enfermedad, detección de metástasis mediastínicas y a distancia, evaluar la naturaleza de la masa residual, análisis de seguimiento tras diversos tratamientos, identificación de recidivas, predicción del pronóstico, así como en la planeación del tratamiento con radioterapia.


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