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Consideration of serum glucose levels during malignant mediastinal lymph node detection in non-small-cell lung cancer by FDG-PET

Cited 8 time in webofscience Cited 9 time in scopus
Authors
Lee, WON WOO; Chung, JIN-HAENG; Jang, SUNG-JUNE; Eo, JAE SEON; Park, SO YEON; Sung, SOOK WHAN; So, YOUNG; Chung, JUNE-KEY; Lee, MYUNG CHUL; Kim, SANG EUN
Issue Date
2006-10-14
Publisher
Wiley-Blackwell
Citation
J Surg Oncol 2006;94(7):607-613.
Keywords
Blood Glucose/*analysisCarcinoma, Non-Small-Cell Lung/blood/*radionuclide imaging/secondaryDiabetes Complications/bloodFluorodeoxyglucose F18/*diagnostic use/pharmacokineticsHumansLung Neoplasms/blood/pathology/*radionuclide imagingLymph Nodes/pathology/*radionuclide imagingLymphatic MetastasisMediastinumROC CurveRadiopharmaceuticals/*diagnostic useSensitivity and Specificity
Abstract
BACKGROUND AND OBJECTIVE: Glucose and FDG compete for uptake by cancers. Here, we undertook to improve diagnostic accuracy of FDG-PET for determining mediastinal lymph node (LN) status in NSCLC by considering serum glucose level. METHODS: NSCLC patients (n = 70) who underwent curative lung resection and mediastinal LN dissection within 1 month of FDG-PET were enrolled. MaxSUV was calculated using lean body weight and used to determine a new parameter (maxSUV x serum glucose level; maxSUV-GL). Histopathologic LN results were compared with maxSUV and maxSUV-GL values. RESULTS: Of 71 LN stations whose FDG uptake could be measured, 21 were malignant and 50 benign. MaxSUV of LN had AUC of 0.729 (95% CI: 0.610-0.827) by ROC analysis with sensitivity of 47.6% (10/21), specificity of 94.0% (47/50), and a cutoff value of 3.3. Using maxSUV-GL the corresponding values were; AUC 0.825 (95% CI: 0.716-0.905) and sensitivity 76.2% (16/21), with a cutoff value of 290.4, which represented a significant improvement (P < 0.01) without compromising specificity 88.0% (44/50) (P > 0.05). The exclusion of neo-adjuvant chemotherapeutic and diabetic patients resulted in a similar improvement in diagnostic accuracy. CONCLUSION: By considering serum glucose level during FDG-PET using the new parameter maxSUV-GL, sensitivity for malignant mediastinal LN detection is improved.
ISSN
0022-4790
Language
English
URI
http://hdl.handle.net/10371/10049
DOI
https://doi.org/10.1002/jso.20624
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College of Medicine/School of Medicine (의과대학/대학원)Pathology (병리학전공)Journal Papers (저널논문_병리학전공)
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