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Differentiation of mediastinal FDG uptake observed in patients with non-thoracic tumours

Authors
 Won Jun Kang  ;  June-Key Chung  ;  Myung Chul Lee  ;  Dong Soo Lee  ;  Jae Min Jeong  ;  Young So 
Citation
 EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, Vol.31(2) : 202-207, 2004 
Journal Title
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN
 1619-7070 
Issue Date
2004
MeSH
Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/pharmacokinetics* ; Humans ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/metabolism* ; Lymphatic Metastasis ; Male ; Mediastinal Neoplasms/diagnosis ; Mediastinal Neoplasms/diagnostic imaging ; Mediastinal Neoplasms/metabolism ; Mediastinum/diagnostic imaging* ; Mediastinum/physiopathology* ; Middle Aged ; Neoplasms, Unknown Primary/diagnosis ; Neoplasms, Unknown Primary/diagnostic imaging* ; Neoplasms, Unknown Primary/metabolism* ; Radionuclide Imaging ; Reproducibility of Results ; Sensitivity and Specificity ; Thoracic Neoplasms/diagnosis ; Thoracic Neoplasms/diagnostic imaging ; Thoracic Neoplasms/metabolism
Keywords
FDG ; Positron emission tomography ; Neoplasm ; Mediastinum ; Lymph nodes
Abstract
In regions with a high prevalence of granulomatous diseases, benign inflammatory fluorine-18 fluorodeoxyglucose (FDG) uptake in the mediastinum is frequently observed even in healthy subjects. We examined parameters of mediastinal FDG uptake to determine whether they can differentiate malignancy from benign lesions. Seventy patients with non-thoracic tumours who had mediastinal uptake on FDG positron emission tomography (PET) were included (33 males, 37 females; age 57.5±16.9 years; 168 lymph nodes). Determination of metastasis was confirmed by biopsy or computed tomography (CT) follow-up over 12 months (metastasis, 29; benign lesions, 41). No significant difference between the metastasis group and the benign group was found in terms of residual disease in the primary site (48% vs 46%), lung invasion (29% vs 20%), number of sites of uptake (2.3 vs 2.4), smoking history (30.3% vs 46.3%) or bilateral uptake (52% vs 54%). Maximal standardised uptake values (SUVs) in the mediastinal metastasis group were higher (4.9±1.8) than those in the benign group (2.5±0.9) (P<0.05). Using 3.4 as a cut-off value for maximal SUV, a sensitivity of 86% and a specificity of 85% were achieved (AUC=0.917). Maximal SUV showed better predictive value than lymph node size measured on chest CT (P<0.05). In 8 of 51 normal subjects who underwent FDG PET as a routine check-up, mediastinal FDG uptake was observed. Maximal SUV in normal subjects was 2.5±0.8, which was similar to that in the benign group. In conclusion, maximal SUV was identified as a significant parameter for determining whether mediastinal FDG uptake represents malignant metastasis. When maximal SUV exceeded 3.4, the metastasis rate was high regardless of lymph node size.
Full Text
http://link.springer.com/article/10.1007%2Fs00259-003-1368-x
DOI
10.1007/s00259-003-1368-x
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/22282913/111239
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