Yoshitaro Saito1, Kazuhiro Imai2, Koichi Ishiyama3, Hajime Saito1, Satoru Motoyama1, Yusuke Sato1, Hayato Konno1, Satoshi Fujishima1, Manabu Hashimoto3, Yoshihiro Minamiya1. 1. Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. 2. Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. i-karo@mui.biglobe.ne.jp. 3. Division of Radiology and Radiation Medicine, Department of Integrated Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Abstract
BACKGROUND: The aim of the present study was to use surgical and histological results to develop a simple noninvasive technique for improving nodal staging using preoperative PET/CT in patients with resectable non-small cell lung cancer (NSCLC). METHODS: Preoperative PET/CT findings (163 patients) and pathological diagnoses after surgical resection were evaluated. Using PET/CT images, lymph node section area (SA), the maximum standardized uptake value (SUVmax), SA of SUV ≥2.5 and ≥3.0 were drawn freehand and measured using caliper software. Receiver operating characteristic (ROC) curves were then used to analyze those data. RESULTS: Based on ROC analyses, the cut-off values for SA of SUV ≥2.5, SA of SUV ≥3.0, SUV ≥2.5 SA/node SA and SUV ≥3.0 SA/node SA for diagnosis of lymph node metastasis were 200 mm2, 30 mm2, 1.0 and 0.4. SUV ≥2.5 SA/node SA ≥1.0 had the highest negative predictive value, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of nodal staging were 61.1, 73.4, 36.7, 88.2 and 70.9%. CONCLUSIONS: When diagnosing nodal staging based a lymph node SUV ≥2.5 SA/node SA ratio of ≥1.0, it can be an effective criterion for use to determine surgical indications.
BACKGROUND: The aim of the present study was to use surgical and histological results to develop a simple noninvasive technique for improving nodal staging using preoperative PET/CT in patients with resectable non-small cell lung cancer (NSCLC). METHODS: Preoperative PET/CT findings (163 patients) and pathological diagnoses after surgical resection were evaluated. Using PET/CT images, lymph node section area (SA), the maximum standardized uptake value (SUVmax), SA of SUV ≥2.5 and ≥3.0 were drawn freehand and measured using caliper software. Receiver operating characteristic (ROC) curves were then used to analyze those data. RESULTS: Based on ROC analyses, the cut-off values for SA of SUV ≥2.5, SA of SUV ≥3.0, SUV ≥2.5 SA/node SA and SUV ≥3.0 SA/node SA for diagnosis of lymph node metastasis were 200 mm2, 30 mm2, 1.0 and 0.4. SUV ≥2.5 SA/node SA ≥1.0 had the highest negative predictive value, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of nodal staging were 61.1, 73.4, 36.7, 88.2 and 70.9%. CONCLUSIONS: When diagnosing nodal staging based a lymph node SUV ≥2.5 SA/node SA ratio of ≥1.0, it can be an effective criterion for use to determine surgical indications.
Authors: Matthew J Schuchert; Brian L Pettiford; Samuel Keeley; Thomas A D'Amato; Arman Kilic; John Close; Arjun Pennathur; Ricardo Santos; Hiran C Fernando; James R Landreneau; James D Luketich; Rodney J Landreneau Journal: Ann Thorac Surg Date: 2007-09 Impact factor: 4.330
Authors: Andreas K Buck; Martin Hetzel; Holger Schirrmeister; Gisela Halter; Peter Möller; Clemens Kratochwil; Andreas Wahl; Gerhard Glatting; Felix M Mottaghy; Torsten Mattfeldt; Bernd Neumaier; Sven N Reske Journal: Eur J Nucl Med Mol Imaging Date: 2004-12-14 Impact factor: 9.236
Authors: David C P Cobben; Philip H Elsinga; Harald J Hoekstra; Albert J H Suurmeijer; Willem Vaalburg; Bram Maas; Pieter L Jager; Harry M J Groen Journal: J Nucl Med Date: 2004-10 Impact factor: 10.057