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Paraaortic lymph node metastasis in patients with intra-abdominal malignancies: CT vs PET

 Mi-Jung Lee  ;  Mi Jin Yun  ;  Mi-Suk Park  ;  Seung Hwan Cha  ;  Myeong-Jin Kim  ;  Jong Doo Lee  ;  Ki Whang Kim 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.15(35) : 4434-4438, 2009 
Journal Title
Issue Date
Abdominal Neoplasms/diagnosis* ; Abdominal Neoplasms/secondary ; Adult ; Aged ; Aorta/diagnostic imaging ; False Negative Reactions ; False Positive Reactions ; Female ; Fluorodeoxyglucose F18 ; Humans ; Image Processing, Computer-Assisted ; Lymphatic Metastasis/diagnostic imaging* ; Male ; Middle Aged ; Positron-Emission Tomography/methods* ; Predictive Value of Tests ; Radiopharmaceuticals ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Tomography, X-Ray Computed/methods*
Malignancy ; Paraaortic lymph node ; Computed tomography ; Positron emission tomography ; Sensitivity ; Specificity
AIM: To compare the diagnostic accuracy of computed tomography (CT) and positron emission tomography (PET) for the preoperative detection of paraaortic lymph node (PAN) metastasis in patients with intra-abdominal malignancies.

METHODS: Sixty-six patients with intra-abdominal malignancies who underwent both CT and PET before lymphadenectomy were included in this study. Histopathologically, 13 patients had metastatic PAN, while 53 had non-metastatic PAN. The CT criteria for metastasis were: short diameter of > 8 mm, lobular or irregular shape, and/or combined ancillary findings, including necrosis, conglomeration, vessel encasement, and infiltration. The PET criterion was positive fluorodeoxyglucose (FDG) uptake. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of both modalities were compared with the pathologic findings, and the false positive and false negative cases with both CT and PET were analyzed.

RESULTS: The sensitivity, specificity, PPV, NPV, and accuracy of CT were 61.5%, 84.9%, 50%, 90% and 80.3%, respectively. For PET, the percentages were 46.2%, 100%, 100%, 88.3%, and 89.4%. Additionally, there were 8 false positive CT cases (8/53, 15.1%) and zero false positive PET cases. Of the 13 metastatic PANs, there were 5 false negative CT scans (38.5%) and 7 (53.9%) false negative PET scans.

CONCLUSION: For detecting PAN metastasis, CT is more sensitive than PET, while PET is more specific.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Lee, Jong Doo(이종두)
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