Title Utilizacija slikovnih metoda prikaza mozga u dijagnostici raka pluća
Title (english) Utilization of brain imaging methods in the diagnostic workup of lung cancer
Author Veronika Vučić
Mentor Tihana Boraska Jelavić (mentor)
Committee member Maja Marinović Guić (predsjednik povjerenstva)
Committee member Tatjana Matijaš (član povjerenstva)
Committee member Tihana Boraska Jelavić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2024-09-19, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Ovaj rad imao je za cilj ponuditi uvid u korisnost i korištenje slikovnih metoda prikaza mozga pacijenata oboljelih od raka pluća dijagnosticiranih u Općoj bolnici Dubrovnik u periodu od 2021. do 2022. godine.
Rak pluća patohistološki dijelimo na 2 glavne skupine: NSCLC (nesitnostanični rak pluća) koji čini oko 85% slučajeva oboljelih od raka pluća i SCLC (sitnostanični rak pluća) koji čini oko 15% slučajeva oboljelih od raka pluća. Glavnim čimbenikom za razvoj raka pluća smatra se pušenje. SCLC je mnogo agresivnija vrsta raka pluća kojeg karakterizira slabija diferencijacija tumorskih stanica i lošija klinička slika. NSCLC je obično manje osjetljiv na terapiju zračenjem i kemoterapiju nego SCLC, ali u usporedbi s NSCLC, SCLC je agresivniji sa kraćim vremenom udvostručenja, većim udjelom rasta i ranijim razvojem metastaza. Radiološka dijagnostika igra iznimno važnu ulogu u otkrivanju, praćenju i liječenju bolesnika s rakom pluća. Pravovremena dijagnoza raka u ranom stadiju ključni je čimbenik poboljšanja prognoze bolesnika s rakom. Stručne onkološke smjernice preporučuju inicijalno radiološko oslikavanje mozga CT-om ili MR-om mozga u svih bolesnika dijagnosticiranih sa stadijem II ili višim stadijima raka pluća. Usprkos smjernicama, prvenstveno zbog logističkih razloga, nedostatka resursa, često se u kliničkoj praksi inicijalna slikovna dijagnostika mozga primjenjuje većinom kod simptomatskih bolesnika. Prisustvo moždanih presadnica pri dijagnozi značajno utječe na strategiju liječenja i prognozu bolesnika. U našem uzroku od sveukupno 107 bolesnika oboljelih od raka pluća, učinjena je inicijalna slikovna dijagnostika mozga (CT/MR mozga) kod 40 od 73 bolesnika (54,8%) sa NSCLC-om te kod 19 od 25 bolesnika (76%) sa SCLC-om.
Inicijalna slikovna dijagnostika (CT/MR) mozga učinjena kod naših bolesnika u navedenom periodu otkrila je prisustvo moždanih presadnica kod čak 31.6% bolesnika sa SCLC-om što je u skladu s literaturnim podacima prema kojima čak 80% bolesnika sa SCLC-om ima dokazane moždane metastaze prisutne u roku od dvije godine od postavljanja dijagnoze. Moždane metastaze utvrđene su kod 37,5% oboljelih od NSCLC-a te možemo reći da je učestalost bolesnika sa NSCLC-om s prisutnim moždanim metastazama nešto viša u odnosu na literaturne podatke prema kojima su inicijalno u 20% bolesnika s NSCLC-om prisutne presadnice mozga, a učestalost raste i do 50% s vremenom.
Zaključno, inicijalna slikovna dijagnostika mozga neizostavan je dijagnostički postupak u većine bolesnika s rakom pluća.
Abstract (english) The aim of this paper was to offer an insight into the usefulness and use of imaging methods for brain imaging of lung cancer patients diagnosed at the General Hospital Dubrovnik in the period from 2021 to 2022.
Lung cancer is pathohistologically divided into 2 main groups: NSCLC (non-small cell lung cancer), which accounts for about 85% of lung cancer cases, and SCLC (small cell lung cancer), which accounts for about 15% of lung cancer cases. Smoking is the main risk factor for developing lung cancer. SCLC is a much more aggressive type of lung cancer that is characterized by weaker tumor cell differentiation and a worse clinical picture. NSCLC is usually less sensitive to chemotherapy and radiation therapy than SCLC, but compared to NSCLC, SCLC is more aggressive with a shorter doubling time, higher growth rate, and earlier development of metastases. Radiological diagnostics play an extremely important role in the detection, monitoring and treatment of patients with lung cancer. Timely diagnosis of cancer at an early stage is a key factor in improving the prognosis of cancer patients. Expert oncology guidelines recommend initial radiological imaging of the brain with MR or CT of the brain in all patients diagnosed with stage II or higher stages of lung cancer. Despite the guidelines, primarily due to logistical reasons and lack of resources, initial imaging of the brain is often used in clinical practice mostly in symptomatic patients. The presence of brain implants at the time of diagnosis significantly affects the treatment strategy and prognosis of the patient. In our case, out of a total of 107 patients with lung cancer, initial brain imaging (CT/MR of the brain) was performed in 40 out of 73 patients (54.8%) with NSCLC and in 19 out of 25 patients (76% ) with SCLC.
The initial imaging diagnostics (CT/MR) of the brain performed in our patients in the mentioned period revealed the presence of brain metastases in as many as 31.6% of patients with SCLC, which is in accordance with literature data, according to which as many as 80% of patients with SCLC have proven brain metastases present within two years of diagnosis. Brain metastases were found in 37.5% of NSCLC patients, so we can say that the frequency of NSCLC patients with brain metastases is somewhat higher compared to literature data, according to which metastases are initially present in 20% of NSCLC patients brain, and the frequency increases up to 50% over time.
In conclusion, initial imaging of the brain is an indispensable diagnostic procedure in most patients with lung cancer.
Keywords
rak pluća
radiologija
metastaze na mozgu
CT
MR
OB Dubrovnik
Keywords (english)
lung cancer
radiology
brain metastases
CT
MRI
General Hospital Dubrovnik
Language croatian
URN:NBN urn:nbn:hr:176:811587
Study programme Title: Graduate University Study Programme of Radiologic Technology Study programme type: university Study level: graduate Academic / professional title: sveučilišni/a magistar/magistra radiološke tehnologije (sveučilišni/a magistar/magistra radiološke tehnologije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-09-19 11:28:07