Improved detection of metastatic lymph nodes in oesophageal squamous cell carcinoma by combined interpretation of fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography

被引：12

作者：

Lee, Ji Young ^{[1
]}

Kim, Young Hwan ^{[2
]}

Park, Yong-Jin ^{[3
]}

Park, Soo Bin ^{[4
]}

Chung, Hyun Woo ^{[5
]}

Zo, Jae Il ^{[6
]}

Shim, Young Mog ^{[6
]}

Lee, Kyung Soo ^{[7
]}

Choi, Joon Young ^{[3
]}

机构：

[1] Jeju Natl Univ, Sch Med, Jeju Natl Univ Hosp, Dept Nucl Med, Jeju, South Korea

[2] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Nucl Med, Seoul, South Korea

[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Nucl Med, 81 Irwon Ro, Seoul 06351, South Korea

[4] Soonchunhyang Univ, Coll Med, Seoul Hosp, Dept Radiol, Seoul, South Korea

[5] Konkuk Univ, Sch Med, Med Ctr, Dept Nucl Med, Seoul, South Korea

[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Thorac & Cardiovasc Surg, Seoul, South Korea

[7] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiol, Seoul, South Korea

来源：

CANCER IMAGING | 2019年 / 19卷 / 1期

关键词：

F-18-FDG; PET; CT; Oesophageal cancer; Lymph node metastasis; SUVmax; CT attenuation; INTEGRATED FDG PET/CT; LUNG-CANCER; COMPUTED-TOMOGRAPHY; F-18-FDG PET/CT; CT; PARAMETERS; SURVIVAL; SPREAD; INVOLVEMENT; PREDICTION;

D O I：

10.1186/s40644-019-0225-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundWe sought to evaluate the diagnostic performance of fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography (F-18-FDG PET/CT) in the detection of metastatic lymph nodes by combined interpretation of PET/CT images in patients with oesophageal squamous cell carcinoma.MethodsTwo hundred three patients with oesophageal squamous cell carcinoma underwent F-18-FDG PET/CT before oesophagectomy and lymph node dissection. Maximum standardized uptake value (SUVmax), mean Hounsfield unit (HU), short axis diameter (size), and visual CT attenuation (high, iso-, low) were evaluated on noncontrast CT and PET images following PET/CT scan. In this combined interpretation protocol, the high attenuated lymph nodes were considered benign, even if the SUVmax value was high. The diagnostic accuracy of each method was compared using the postoperative histologic result as a reference standard.ResultsA total of 1099 nodal stations were dissected and 949 nodal stations were proven to demonstrate metastasis. SUVmax and size of the malignant lymph nodes were higher than those of the benign nodes, and visual CT attenuation was significantly different among the two groups (P<0.001). Using cutoff values of 2.6 for SUVmax and 10.2mm for size, the combined interpretation of an SUVmax of more than 2.6 with iso- or low CT attenuation [area under the curve (AUC): 0.846, 95% confidence interval (CI): 0.824-0.867] showed significantly better diagnostic performance for detecting malignant lymph nodes than SUVmax only (AUC: 0.791, 95% CI: 0.766-0.815) and size (AUC: 0.693, 95% CI: 0.665-0.720) methods (P<0.001) in a receiver operating characteristic curve analysis.ConclusionsThe diagnostic accuracy of PET/CT for nodal metastasis in oesophageal squamous cell carcinoma was improved by the combined interpretation of F-18-FDG uptake and visual CT attenuation pattern.

引用

页数：8

共 33 条

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