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(18)F-FDG PET/CT in mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic country: consideration of lymph node calcification and distribution pattern to improve specificity

Cited 47 time in Web of Science Cited 52 time in Scopus
Authors
Lee, Jeong Won; Kim, Bom Sahn; Lee, Dong Soo; Chung, June-Key; Kim, Soonhag; Kang, Won Jun; Lee, Myung Chul
Issue Date
2009-11
Publisher
SPRINGER
Citation
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING; Vol.36 11; 1794-1802
Keywords
Lung cancerPositron emission tomography (PET)(18)F-Fluorodeoxyglucose (FDG)Staging
Abstract
The aim of the study was to assess the accuracy of (18)F-fluorodeoxyglucose (FDG) PET/CT in mediastinal lymph node staging of patients with non-small-cell lung cancer (NSCLC) in a region with a high prevalence of granulomatous disease. Between March 2004 and February 2006, all patients with NSCLC underwent FDG PET/CT and contrast-enhanced thoracic CT, and subsequent surgical resection. PET/CT and contrast-enhanced CT images of 182 patients (126 men and 56 women; mean age 60.7 years) with NSCLC were acquired. Mediastinal node staging was determined using the American Joint Committee on Cancer (AJCC) staging system. Surgical and histological findings served as the reference standard. A total of 182 patients with 778 mediastinal node stations were evaluated. Sensitivity and specificity of contrast-enhanced CT were 36% and 80% on a per-patient basis and 23% and 92% on a per-node station basis. Sensitivity and specificity of PET/CT were 81% and 73% on a per-patient basis and 75% and 85% on a per-node station basis. After lymph nodes with calcification and bilateral hilar distribution were considered benign, sensitivity and specificity of PET/CT were 75% and 89% on a per-patient basis and 66% and 96% on a per-node station basis. This prospective study suggests that FDG PET/CT can more accurately stage mediastinal lymph nodes than CT. Considering lymph node calcification and distribution pattern could improve specificity at the cost of a decrease in sensitivity.
ISSN
1619-7070
Language
English
URI
http://hdl.handle.net/10371/78284
DOI
https://doi.org/10.1007/s00259-009-1155-4
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College of Medicine/School of Medicine (의과대학/대학원)Nuclear Medicine (핵의학전공)Journal Papers (저널논문_핵의학전공)
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