PURPOSE: This study was to compare (18)F-FDG positron emission tomography (PET) with thoracic contrast-enhanced CT (CECT) in the ability of lymph node (LN) staging non-small cell lung cancer (NSCLC) in a tuberculosis-prevalent country. The usefulness of dual time point PET imaging (DTPI) in NSCLC nodal staging was also evaluated. METHODS: We reviewed 96 NSCLC patients (mean age, 65.3+/-11.7 years) who had received PET studies before their surgery. DTPI were performed on 37 patients (mean age, 64.8+/-12.2 years) who received an additional scan of thorax 3 h after tracer injection. The accuracies of nodal staging by CECT and PET were evaluated according to final histopathology of hilar and mediastinal LN resected by surgery. RESULTS: The accuracy for nodal staging by CECT was 65.6% and that by PET was 82.3% (p<0.05). Six patients were over-staged and 11 were under-staged by PET. Tuberculosis (n=3, 50%) were mostly responsible for false-positive, while small tumor foci (n=7, 63.6%) were mostly accountable for false-negative. For the 37 patients with DTPI, 45 min standardized uptake value (SUV) and 3 h SUV for negative LNs are significantly lower than those for positive LNs (p<0.0001). Nevertheless, the retention index (RI) showed no significant difference between these two groups. CONCLUSIONS: Our study demonstrates that PET is more accurate than CECT in LN staging NSCLC patients in Taiwan where TB is still prevalent. Semi-quantitative SUV method or DTPI with RI does not result in better diagnostic accuracy than visual analysis of PET images.
PURPOSE: This study was to compare (18)F-FDG positron emission tomography (PET) with thoracic contrast-enhanced CT (CECT) in the ability of lymph node (LN) staging non-small cell lung cancer (NSCLC) in a tuberculosis-prevalent country. The usefulness of dual time point PET imaging (DTPI) in NSCLC nodal staging was also evaluated. METHODS: We reviewed 96 NSCLCpatients (mean age, 65.3+/-11.7 years) who had received PET studies before their surgery. DTPI were performed on 37 patients (mean age, 64.8+/-12.2 years) who received an additional scan of thorax 3 h after tracer injection. The accuracies of nodal staging by CECT and PET were evaluated according to final histopathology of hilar and mediastinal LN resected by surgery. RESULTS: The accuracy for nodal staging by CECT was 65.6% and that by PET was 82.3% (p<0.05). Six patients were over-staged and 11 were under-staged by PET. Tuberculosis (n=3, 50%) were mostly responsible for false-positive, while small tumor foci (n=7, 63.6%) were mostly accountable for false-negative. For the 37 patients with DTPI, 45 min standardized uptake value (SUV) and 3 h SUV for negative LNs are significantly lower than those for positive LNs (p<0.0001). Nevertheless, the retention index (RI) showed no significant difference between these two groups. CONCLUSIONS: Our study demonstrates that PET is more accurate than CECT in LN staging NSCLCpatients in Taiwan where TB is still prevalent. Semi-quantitative SUV method or DTPI with RI does not result in better diagnostic accuracy than visual analysis of PET images.
Authors: R M Pieterman; J W van Putten; J J Meuzelaar; E L Mooyaart; W Vaalburg; G H Koëter; V Fidler; J Pruim; H J Groen Journal: N Engl J Med Date: 2000-07-27 Impact factor: 91.245
Authors: Barbara M Fischer; Minna W B Olsen; Carsten D Ley; Thomas L Klausen; Jann Mortensen; Liselotte Højgaard; Paul E G Kristjansen Journal: Eur J Nucl Med Mol Imaging Date: 2006-04-13 Impact factor: 9.236
Authors: J F Vansteenkiste; S G Stroobants; P R De Leyn; P J Dupont; J Bogaert; A Maes; G J Deneffe; K L Nackaerts; J A Verschakelen; T E Lerut; L A Mortelmans; M G Demedts Journal: J Clin Oncol Date: 1998-06 Impact factor: 44.544