FDG PET/CT and Mediastinal Nodal Metastasis Detection in Stage T1 Non-Small Cell Lung Cancer: Prognostic Implications
Korean Journal of Radiology
;
: 481-489, 2008.
Article
in English
| WPRIM
| ID: wpr-43032
ABSTRACT
OBJECTIVE:
We aimed to compare the prognoses of patients with pathologically true negative (P-TN) N2 and PET/CT false negative (FN) results in stage T1 non-small cell lung cancer (NSCLC). MATERIALS ANDMETHODS:
Our institutional review board approved this retrospective study with a waiver of informed consent. The study included 184 patients (124 men and 60 women; mean age, 59 years) with stage T1 NSCLC who underwent an integrated PET/CT and surgery. After estimating the efficacy of PET/CT for detecting N2 disease, we determined and compared disease-free survival (DFS) rates in three groups (P-TN [n = 161], PET/CT FN [n = 12], and PET/CT true positive [TP, n = 11]) using the Kaplan-Meier analysis and log-rank test.RESULTS:
Pathologic N2 disease was observed in 23 (12%) patients. PET/CT had an N2 disease detection sensitivity of 48% (11 of 23 patients), a specificity of 95% (153 of 161), and an accuracy of 89% (164 of 184). The 3-year DFS rate in the PET/CT FN group (31%, 95% confidence interval [CI]; 13.6-48.0%) was similar to that of the TP group (16%, 95% CI; 1.7-29.5%) (p = 0.649), but both groups had significantly shorter DFS rates than the P-TN group (77%, 95% CI; 72.0-81.2%) (p < 0.001).CONCLUSION:
The PET/CT shows a high specificity, but low sensitivity for detecting N2 disease in stage T1 NSCLC. Patients with PET/CT FN N2 disease have survival rates similar to PET/CT TP N2 disease patients, which are both substantially shorter than the survival rate of P-TN patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Tomography, X-Ray Computed
/
Survival Rate
/
Sensitivity and Specificity
/
Carcinoma, Non-Small-Cell Lung
/
Disease-Free Survival
/
Radiopharmaceuticals
/
Fluorodeoxyglucose F18
/
Positron-Emission Tomography
/
Lung Neoplasms
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Korean Journal of Radiology
Year:
2008
Type:
Article
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