Document Detail


Efficacy of helical dynamic CT versus integrated PET/CT for detection of mediastinal nodal metastasis in non-small cell lung cancer.
MedLine Citation:
PMID:  17242237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of our study was to compare the diagnostic efficacies of helical dynamic CT and integrated PET/CT for the prediction of mediastinal nodal metastasis in stage T1 non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: One hundred forty-three patients with stage T1 NSCLC underwent both helical dynamic CT and integrated PET/CT followed by surgical nodal staging. In helical dynamic CT, patients were regarded to have stage N2 disease when a nodule showed a peak enhancement > or = 110 H or a net enhancement > or = 60 H. In integrated PET/CT, nodes were regarded as positive for malignancy when they showed > or = 3.5 in maximum standardized uptake value with a discrete margin and more 18F-FDG uptake than mediastinal structures. Sensitivities, specificities, and accuracies for mediastinal nodal metastasis detection were compared for helical dynamic CT and integrated PET/CT using the McNemar test. RESULTS: Of the 143 patients, 34 (24%) had positive mediastinal nodes. The sensitivity, specificity, and accuracy for mediastinal nodal metastasis prediction on helical dynamic CT were 65% (22 of 34 patients), 89% (97 of 109), and 83% (119 of 143), respectively, whereas those on integrated PET/CT were 56% (19 of 34), 100% (109 of 109), and 90% (128 of 143). The p values were 0.664, < 0.001, and 0.015. CONCLUSION: In stage T1 NSCLC, contrast-enhanced helical dynamic CT better predicts, but not significantly so, mediastinal nodal metastasis than PET/CT, whereas PET/CT shows perfect specificity and higher accuracy than helical dynamic CT.
Authors:
Chin A Yi; Kyung Soo Lee; Byung-Tae Kim; Sung Shine Shim; Myung Jin Chung; Yon Mi Sung; Sun Young Jeong
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  188     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-23     Completed Date:  2007-02-20     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  318-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carcinoma, Non-Small-Cell Lung / diagnosis*,  secondary*
Female
Humans
Image Enhancement / methods*
Image Interpretation, Computer-Assisted / methods
Lung Neoplasms / diagnosis*
Lymph Nodes / radiography,  radionuclide imaging
Lymphatic Metastasis
Male
Mediastinum / radiography,  radionuclide imaging
Middle Aged
Positron-Emission Tomography / methods*
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique*
Systems Integration
Tomography, Spiral Computed / methods*

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