Ratio of Mediastinal Lymph Node SUV to Primary Tumor SUV in 18F-FDG PET/CT for Nodal Staging in Non-Small-Cell Lung Cancer

被引：26
作者：
Cho J. [1 ]
Choe J.G. [1 ]
Pahk K. [1 ]
Choi S. [1 ]
Kwon H.R. [1 ]
Eo J.S. [2 ]
Seo H.J. [2 ]
Kim C. [3 ]
Kim S. [1 ]
机构：
[1] Department of Nuclear Medicine, Korea University Anam Hospital, Seoul
[2] Department of Nuclear Medicine, Korea University Guro Hospital, Seoul
[3] Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do
来源：
Nuclear Medicine and Molecular Imaging | 2017年 / 51卷 / 2期
关键词：
!sup]18[!/sup]F-FDG PET/CT; Mediastinal lymph node; Non-small-cell lung cancer; SUV;
D O I：
10.1007/s13139-016-0447-4
中图分类号：
学科分类号：
摘要：
Purpose: Following determination of the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes (SUV-LN) and of the primary tumor (SUV-T) on 18F-FDG PET/CT in patients with non-small-cell lung cancer (NSCLC), the aim of the study was to determine the value of the SUV-LN/SUV-T ratio in lymph node staging in comparison with that of SUV-LN. Methods: We retrospectively reviewed a total of 289 mediastinal lymph node stations from 98 patients with NSCLC who were examined preoperatively for staging and subsequently underwent pathologic studies of the mediastinal lymph nodes. We determined SUV-LN and SUV-R for each lymph node station on 18F-FDG PET/CT and then classified each station into one of three groups based on SUV-T (low, medium and high SUV-T groups). Diagnostic performance was assessed based on receiver operating characteristic (ROC) curve analysis, and the optimal cut-off values that would best discriminate metastatic from benign lymph nodes were determined for each method. Results: The average of SUV-R of malignant lymph nodes was significantly higher than that of benign lymph nodes (0.79 ± 0.45 vs. 0.36 ± 0.23, P < 0.0001). In the ROC curve analysis, the area under the curve (AUC) of SUV-R was significantly higher than that of SUV-LN in the low SUV-T group (0.885 vs. 0.810, P = 0.019). There were no significant differences between the AUCs of SUV-LN and of SUV-R in the medium and high SUV-T groups. The optimal cut-off value for SUV-R in the low SUV-T group was 0.71 (sensitivity 87.5 %, specificity 85.9 %). Conclusions: The SUV-R performed well in distinguishing between metastatic and benign lymph nodes. In particular, SUV-R was found to have a better diagnostic performance than SUV-LN in the low SUV-T group. © 2016, Korean Society of Nuclear Medicine.
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页码：140 / 146
页数：6
相关论文
共 33 条
[1]  
Dwamena B.A., Sonnad S.S., Angobaldo J.O., Wahl R.L., Metastases from non-small cell lung cancer: mediastinal staging in the 1990s – meta-analytic comparison of PET and CT, Radiology, 213, pp. 530-536, (1999)
[2]  
Ettinger D.S., Wood D.E., Akerley W., Bazhenova L.A., Borghaei H., Camidge D.R., Et al., Non-small cell lung cancer, version 6.2015, J Natl Compr Cancer Netw, 13, pp. 515-524, (2015)
[3]  
Silvestri G.A., Gonzalez A.V., Jantz M.A., Margolis M.L., Gould M.K., Tanoue L.T., Et al., Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines, Chest, 143, pp. e211S-eS250, (2013)
[4]  
Rivera M.P., Mehta A.C., Wahidi M.M., Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines, Chest, 143, pp. e142S-eS165, (2013)
[5]  
Ost D.E., Yeung S.C., Tanoue L.T., Gould M.K., Clinical and organizational factors in the initial evaluation of patients with lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines, Chest, 143, pp. 121-141, (2013)
[6]  
Shim S.S., Lee K.S., Kim B.T., Chung M.J., Lee E.J., Han J., Et al., Non-small cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging, Radiology, 236, pp. 1011-1019, (2005)
[7]  
An Y.S., Sun J.S., Park K.J., Hwang S.C., Park K.J., Sheen S.S., Et al., Diagnostic performance of (18)F-FDG PET/CT for lymph node staging in patients with operable non-small-cell lung cancer and inflammatory lung disease, Lung, 186, pp. 327-336, (2008)
[8]  
Turkmen C., Sonmezoglu K., Toker A., Yilmazbayhan D., Dilege S., Halac M., Et al., The additional value of FDG PET imaging for distinguishing N0 or N1 from N2 stage in preoperative staging of non-small cell lung cancer in region where the prevalence of inflammatory lung disease is high, Clin Nucl Med, 32, pp. 607-612, (2007)
[9]  
Chao F., Zhang H., PET/CT in the staging of the non-small-cell lung cancer, J Biomed Biotechnol, 2012, (2012)
[10]  
Steinert H.C., Hauser M., Allemann F., Engel H., Berthold T., von Schulthess G.K., Et al., Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling, Radiology, 202, pp. 441-446, (1997)
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