Flare Response versus Disease Progression in Patients with Non-small Cell Lung Cancer.Flare Response versus Disease Progression in Patients with Non-small Cell Lung Cancer

Authors

  • Khalsa Al-Nabhani
  • Rizwan Syed
  • Athar Haroon
  • Omar Almukhailed
  • Jamshed Bomanji

DOI:

https://doi.org/10.3941/jrcr.v6i11.1109

Keywords:

Flare phenomena, non-small cell lung cancer, NSCLC, 18F-FDG PET/CT, erlotinib, disease progression

Abstract

We present a case report of a patient with metastatic non-small cell lung cancer (NSCLC) who had a serial of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans for assessment of response to treatment.  A restaging 18F-FDG PET/CT scan after six cycles showed increased FDG activity in the bone lesions with reduced activity in the lung and liver lesions. The increased bone activity was considered to be due to flare phenomenon rather than metastasis. A short interval follow up scan after 1 month was advised to confirm this interpretation but this repeat scan showed disease relapse. Although the flare phenomenon does exist, caution should be exercised in attributing increased tracer uptake in the lesions in patients with adenocarcinoma of lung and especially those who have received erlotinib during the course of their treatment. Distinguishing the 'flare phenomenon' and 'disease progression' is at times difficult but is important since misdiagnosis may result in an unnecessary delay in patient management.

Author Biographies

Khalsa Al-Nabhani

Nuclear Medicine Fellow (Specialist Registrar).  Institute of Nuclear Medicine. University College London Hospitals

Rizwan Syed

Consultant radiologist and nuclear medicine. Institute of Nuclear Medicine. University College London Hospitals

Athar Haroon

Nuclear Medicine Fellow (Specialist Registrar).  Institute of Nuclear Medicine. University College London Hospitals

Omar Almukhailed

Nuclear Medicine Fellow .Institute of Nuclear Medicine. University College London Hospitals

Jamshed Bomanji

Consultant and head of department of Institute of Nuclear Medicine. University College London Hospitals

Journal of Radiology Case Reports November 2012 issue - Flare Response versus Disease Progression in Patients with Non-small Cell Lung Cancer by Al-Nabhani et al.

Downloads

Published

2012-11-19

Issue

Vol. 6 No. 11 (2012)

Section

Nuclear Medicine / Molecular Imaging

License

The publisher holds the copyright to the published articles and contents. However, the articles in this journal are open-access articles distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License, which permits reproduction and distribution, provided the original work is properly cited. The publisher and author have the right to use the text, images and other multimedia contents from the submitted work for further usage in affiliated programs. Commercial use and derivative works are not permitted, unless explicitly allowed by the publisher.