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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.

Authors
 Jeong Won Lee  ;  Bom Sahn Kim  ;  Dong Soo Lee  ;  June-Key Chung  ;  Myung Chul Lee  ;  Soonhag Kim  ;  Won Jun Kang 
Citation
 EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, Vol.36(11) : 1794-1802, 2009 
Journal Title
 EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 
ISSN
 1619-7070 
Issue Date
2009
MeSH
Calcinosis* ; Carcinoma, Non-Small-Cell Lung/complications ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/pathology* ; Contrast Media ; Endemic Diseases ; False Positive Reactions ; Female ; Fluorodeoxyglucose F18*/metabolism ; Humans ; Lung Neoplasms/complications ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology* ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology* ; Male ; Mediastinum* ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Radiography, Thoracic ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tuberculosis/complications* ; Tuberculosis/epidemiology
Keywords
Lung cancer ; Positron emission tomography (PET) ; 18F-Fluorodeoxyglucose (FDG) ; Staging
Abstract
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.
Full Text
http://link.springer.com/article/10.1007%2Fs00259-009-1155-4
DOI
10.1007/s00259-009-1155-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104398
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