|Title:||18F-FDG PET for the lymph node staging of non-small cell lung cancer in a tuberculosis-endemic country: Is dual time point imaging worth the effort?||Authors:||Yen R.-F.
|Issue Date:||2008||Journal Volume:||35||Journal Issue:||7||Start page/Pages:||1305-1315||Source:||European Journal of Nuclear Medicine and Molecular Imaging||Abstract:||
Purpose: This study was to compare 18F-FDG positron emission tomography (PET) with thoracic contrast-enhanced CT (CECT) in the ability of lymph node (LN) staging non-small cell lung cancer (NSCLC) in a tuberculosis-prevalent country. The usefulness of dual time point PET imaging (DTPI) in NSCLC nodal staging was also evaluated. Methods: We reviewed 96 NSCLC patients (mean age, 65.3 ± 11.7 years) who had received PET studies before their surgery. DTPI were performed on 37 patients (mean age, 64.8 ± 12.2 years) who received an additional scan of thorax 3 h after tracer injection. The accuracies of nodal staging by CECT and PET were evaluated according to final histopathology of hilar and mediastinal LN resected by surgery. Results: The accuracy for nodal staging by CECT was 65.6% and that by PET was 82.3% (p < 0.05). Six patients were over-staged and 11 were under-staged by PET. Tuberculosis (n = 3, 50%) were mostly responsible for false-positive, while small tumor foci (n = 7, 63.6%) were mostly accountable for false-negative. For the 37 patients with DTPI, 45 min standardized uptake value (SUV) and 3 h SUV for negative LNs are significantly lower than those for positive LNs (p < 0.0001). Nevertheless, the retention index (RI) showed no significant difference between these two groups. Conclusions: Our study demonstrates that PET is more accurate than CECT in LN staging NSCLC patients in Taiwan where TB is still prevalent. Semi-quantitative SUV method or DTPI with RI does not result in better diagnostic accuracy than visual analysis of PET images. ? 2008 Springer-Verlag.
|ISSN:||1619-7070||DOI:||10.1007/s00259-008-0733-1||metadata.dc.subject.other:||fluorodeoxyglucose f 18; tracer; diagnostic agent; fluorodeoxyglucose f 18; radiopharmaceutical agent; adult; aged; article; cancer staging; computer assisted tomography; contrast enhancement; diagnostic accuracy; diagnostic imaging; diagnostic value; drug retention; dual time point imaging; false negative result; false positive result; female; human; human cell; human tissue; intermethod comparison; lung non small cell cancer; lymph node biopsy; major clinical study; male; positron emission tomography; prevalence; standardization; Taiwan; tuberculosis; comparative study; evaluation; laboratory diagnosis; lung non small cell cancer; lung tuberculosis; lung tumor; lymph node metastasis; metastasis; methodology; middle aged; scintiscanning; Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; False Positive Reactions; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Radiopharmaceuticals; Taiwan; Tomography, X-Ray Computed; Tuberculosis, Pulmonary
|Appears in Collections:||醫學系|
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