Integrated positron emission tomography and computed tomography in preoperative lymph node staging of non-small cell lung cancer / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 607-613, 2014.
Article
in English
| WPRIM
| ID: wpr-317932
ABSTRACT
<p><b>BACKGROUND</b>Integrated positron emission tomography and computed tomography (PET/CT) is increasingly used for the preoperative nodal staging of non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the accuracy of PET/CT in comparison with CT in detection of nodal metastasis and preoperative nodal staging in patients with NSCLC, and to analyze the causes of the PET/CT false-negative and false-positive results.</p><p><b>METHODS</b>Consecutive patients with pathologically proven NSCLC who underwent staging using PET/CT from July 2008 to February 2012 were evaluated retrospectively. Nodal staging was pathologically confirmed on tissue specimens obtained at thoracotomy. The accuracy of PET/CT and CT in the assessment of intrathoracic nodal involvement was determined using histological results as the reference standard. Logistic regression was used to define the causes of the false-negative and false-positive results.</p><p><b>RESULTS</b>A total of 528 lymph node stations were evaluated in 101 patients. Lymph nodes were positive for malignancy in 43 out of 101 patients (42.6%), and 101 out of 528 nodal stations (19.2%). PET/CT was significantly more accurate for nodal staging than CT. The sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT for detecting nodal metastasis were 51.5%, 95.8%, 74.3%, 89.3%, and 87.3% and the corresponding data by CT were 45.5%, 87.1%, 45.5%, 87.1%, and 79.2%, respectively. PET/CT confers significantly higher specificity, positive predictive value, and accuracy than CT in detecting nodal metastasis. False-negative results by PET/CT are significantly associated with smaller lymph node size, whereas false-positive results are related to a combination of inflammatory disorders and larger lymph node size.</p><p><b>CONCLUSION</b>PET/CT confers significantly higher accuracy than CT in nodal staging, and is more specific and accurate than CT in detecting nodal metastasis but has a low sensitivity and high false-negative rate.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Tomography, X-Ray Computed
/
Retrospective Studies
/
Sensitivity and Specificity
/
Carcinoma, Non-Small-Cell Lung
/
Positron-Emission Tomography
/
Preoperative Period
/
Multimodal Imaging
/
Lung Neoplasms
/
Lymph Nodes
Type of study:
Diagnostic study
/
Observational study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Medical Journal
Year:
2014
Type:
Article
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