The Role of PET-CT in Mediastinal Lymph Node Staging in Non-small Cell Lung Cancer

被引:0
作者
Bellek, Ebru [1 ]
Erturan, Salih Serdar [1 ]
Hallac, Metin [3 ]
Sonmezoglu, Kerim [3 ]
Kaynak, Kamil [2 ]
Bozkurt, Kursat [2 ]
Akman, Canan [4 ]
Oz, Buge [5 ]
Yaman, Mustafa [1 ]
机构
[1] Istanbul Univ, Cerrahpasa Tip Fak, Gogus Hastaliklari AD, Istanbul, Turkey
[2] Istanbul Univ, Cerrahpasa Tip Fak, Gogus Cerrahisi AD, Istanbul, Turkey
[3] Istanbul Univ, Cerrahpasa Tip Fak, Nukleer Tip AD, Istanbul, Turkey
[4] Istanbul Univ, Cerrahpasa Tip Fak, Radyol AD, Istanbul, Turkey
[5] Istanbul Univ, Cerrahpasa Tip Fak, Patol AD, Istanbul, Turkey
关键词
positron emission tomography (PET); standart uptake value (SUV);
D O I
暂无
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Aim: The aim of this study was to determine the overall accuracy, sensitivity and specificity of both CT and PET-CT in identifying and classifying the presence of metastatic intra-thoracic lymph nodes and their potential role in the treatment of lung cancer. Material and methods: Forty four (mean age 60.7, male/female ratio: 37/7) patients with potentially resectable non-small cell lung cancer have been enrolled. All patients underwent flexibl bronchoscopy, CT scanning and PET-CT imaging prior to mediastinoscopy. Mediastinostomy was performed in two patients. Thirty three patients with negative mediastinoscopy and three patients after neoadjuvant chemotherapy, total of 37 patients went through thoracotomy. Results: The overall sensitivity, specificity and accuracy of CT scan in preoperative staging were found 66.7%, 62.1%, 63.6%, respectively. The negative and positive predictive values of CT scan were 78.3% and 47.6%. CT imaging correctly identified 29 patients (65.9%). Seven patients (15.9%) were under-staged while eight patients (18.1%) were over-staged. Based on PETCT findings, overall sensitivity, specificity and accuracy for staging mediastinal lymph nodes were 86.7%, 65.5% and 72.7%, respectively. The negative and positive predictive values of PET-CT were as follows; 90.5% and 56.5%. Overall, interpretations based on PET-CT staged 65.9% (29 patients) correctly, down-staged six patients (13.6%) and over-staged nine patients. The false-negative rate was 13.3% while the false-positive rate was 34.5%. Conclusion: CT scan and PET-CT perform similarly in the mediastinal staging of non-small cell lung cancer (p= 0.05, Mc Nemar test), both tests are conditionally dependent and provide complementary information, and their diagnostic value mainly resides on the negative results. Although, statistically insignificant, PET-CT has a superior sensitivity and better negative predictive value over CT scan. Based on the relationship between SUV-max value and characteristics of tumor, a significant increase in SUV-max value appeared to be correlated with the tumor size and squamous cell carcinoma sub-type.
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页码:13 / 20
页数:8
相关论文
共 13 条
[1]   Staging of the mediastinum: Value of positron emission tomography imaging in non-small cell lung cancer [J].
Bury, T ;
Paulus, P ;
Dowlati, A ;
Corhay, JL ;
Weber, T ;
Ghaye, B ;
Schoffers, J ;
Limet, R ;
Albert, A ;
Rigo, P ;
Radermecker, M .
EUROPEAN RESPIRATORY JOURNAL, 1996, 9 (12) :2560-2564
[2]   Seeking a home for a PET, Part 2 - Defining the appropriate place for positron emission tomography imaging in the staging of patients with suspected lung cancer [J].
Detterbeck, FC ;
Falen, S ;
Rivera, MP ;
Halle, JS ;
Socinski, MA .
CHEST, 2004, 125 (06) :2300-2308
[3]   Cancer statistics, 2001 [J].
Greenlee, RT ;
Hill-Harmon, MB ;
Murray, T ;
Thun, M .
CA-A CANCER JOURNAL FOR CLINICIANS, 2001, 51 (01) :15-36
[4]   Mediastinal lymph node sampling following positron emission tomography with fluorodeoxyglucose imaging in lung cancer staging [J].
Gupta, NC ;
Tamim, WJ ;
Graeber, GG ;
Bishop, HA ;
Hobbs, GR .
CHEST, 2001, 120 (02) :521-527
[5]   Evaluation of healthcare, resource utilization (HRU) and costs of anemia among chronic obstructive pulmonary disease (COPD) patients [J].
Halpern, MT ;
Schmier, JK ;
Zilberberg, M ;
Lau, E .
CHEST, 2005, 128 (04) :257S-257S
[6]   Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography [J].
Lardinois, D ;
Weder, W ;
Hany, TF ;
Kamel, EM ;
Korom, S ;
Seifert, B ;
von Schulthess, GK ;
Steinert, HC .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (25) :2500-2507
[7]   Accuracy of helical computed tomography and [18F] fluorodeoxyglucose positron emission tomography for identifying lymph node mediastinal metastases in potentially resectable non-small-cell lung cancer [J].
Pozo-Rodríguez, F ;
de Nicolás, JLM ;
Sánchez-Nistal, MA ;
Maldonado, A ;
de Barajas, SG ;
Calero-García, R ;
Pozo, MA ;
Martín-Escribano, P ;
Martín-García, I ;
García-Lujan, R ;
Lopez-Encuentra, A ;
de Pablo, AA .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (33) :8348-8356
[8]  
Ravens-Fritscher A, 2003, CHEST, V123, P442
[9]   The role of PET scan in diagnosis, staging, and management of non-small cell lung cancer [J].
Schrevens, L ;
Lorent, N ;
Dooms, C ;
Vansteenkiste, J .
ONCOLOGIST, 2004, 9 (06) :633-643
[10]  
Scott WJ, 1999, CLIN PULM MED, V6, P198