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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 10 time in
Web of Science
Cited 10 time in Scopus
- Authors
- Issue Date
- 2006-10-14
- Publisher
- John Wiley & Sons
- Citation
- J Surg Oncol. 2006 Dec 1;94(7):607-13.
- Keywords
- Blood Glucose/*analysis ; Carcinoma, Non-Small-Cell Lung/blood/*radionuclide imaging/secondary ; Diabetes Complications/blood ; Fluorodeoxyglucose F18/*diagnostic use/pharmacokinetics ; Humans ; Lung Neoplasms/blood/pathology/*radionuclide imaging ; Lymph Nodes/pathology/*radionuclide imaging ; Lymphatic Metastasis ; Mediastinum ; ROC Curve ; Radiopharmaceuticals/*diagnostic use ; Sensitivity 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 (Print)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17039492
https://hdl.handle.net/10371/27822
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