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18F-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

Title
18F-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
Authors
Lee J.W.Kim B.S.Lee D.S.Chung J.-K.Lee M.C.Kim S.Kang W.J.
Ewha Authors
김범산
SCOPUS Author ID
김범산scopus
Issue Date
2009
Journal Title
European Journal of Nuclear Medicine and Molecular Imaging
ISSN
1619-7070JCR Link
Citation
vol. 36, no. 11, pp. 1794 - 1802
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Purpose: The aim of the study was to assess the accuracy of 18F-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. Methods: 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. Results: 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. Conclusion: 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. © 2009 Springer-Verlag.
DOI
10.1007/s00259-009-1155-4
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의학전문대학원 > 의학과 > Journal papers
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