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
em En
| WPRIM
| ID: wpr-317932
Biblioteca responsável:
WPRO
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>
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Índice:
WPRIM
Assunto principal:
Patologia
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Tomografia Computadorizada por Raios X
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Estudos Retrospectivos
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Sensibilidade e Especificidade
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Carcinoma Pulmonar de Células não Pequenas
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Tomografia por Emissão de Pósitrons
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Período Pré-Operatório
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Imagem Multimodal
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Neoplasias Pulmonares
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Linfonodos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Chinese Medical Journal
Ano de publicação:
2014
Tipo de documento:
Article