PURPOSE: 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. 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.
PURPOSE: 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. 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.
Authors: A F T Verhagen; G P Bootsma; V C G Tjan-Heijnen; G J van der Wilt; A L Cox; M H J Brouwer; F H M Corstens; W J G Oyen Journal: Lung Cancer Date: 2004-05 Impact factor: 5.705
Authors: T C McLoud; P M Bourgouin; R W Greenberg; J P Kosiuk; P A Templeton; J A Shepard; E H Moore; J C Wain; D J Mathisen; H C Grillo Journal: Radiology Date: 1992-02 Impact factor: 11.105
Authors: Didier Lardinois; Walter Weder; Thomas F Hany; Ehab M Kamel; Stephan Korom; Burkhardt Seifert; Gustav K von Schulthess; Hans C Steinert Journal: N Engl J Med Date: 2003-06-19 Impact factor: 91.245
Authors: Won Jun Kang; June-Key Chung; Young So; Jae Min Jeong; Dong Soo Lee; Myung Chul Lee Journal: Eur J Nucl Med Mol Imaging Date: 2004-02 Impact factor: 9.236
Authors: Sang Min Lee; Chang Min Park; Jin Chul Paeng; Hyung Jun Im; Jin Mo Goo; Hyun-Ju Lee; Chang Hyun Kang; Young Whan Kim; Jung Im Kim Journal: Eur Radiol Date: 2012-02-24 Impact factor: 5.315
Authors: Sang Min Lee; Jin Mo Goo; Chang Min Park; Soon Ho Yoon; Jin Chul Paeng; Gi Jeong Cheon; Young Tae Kim; Young Sik Park Journal: Eur Radiol Date: 2016-02-16 Impact factor: 5.315