| Preoperative staging of mesothelioma by 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography fused imaging and mediastinoscopy compared to pathological findings after extrapleural pneumonectomy. | |
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MedLine Citation:
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PMID: 18799318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Extrapleural pneumonectomy (EPP) in MPM may be confined with both morbidity and mortality and careful preoperative staging identifying resectable patients is important. Staging is difficult and the accuracy of preoperative CT scan, 18F-FDG PET/CT scan (PET/CT), and mediastinoscopy is unclear. The objectives were to compare these staging techniques to each other and to surgical-pathological findings. METHODS: Patients had epithelial subtype MPM, age <or=70 years, and lung function test allowing pneumonectomy. Preoperative staging after 3-6 courses of induction chemotherapy included conventional CT scan, PET/CT, and mediastinoscopy. Surgical-pathological findings were compared to preoperative findings. RESULTS: Forty-two consecutive patients were without T4 or M on CT scan. PET/CT showed inoperability in 12 patients (29%) due to T4 (7 patients) and M1 (7 patients). Among 30 patients with subsequent mediastinoscopy, including 10 with N2/N3 on PET/CT, N2 were histologically verified in 6 (20%). Among 24 resected patients, T4 occurred in 2 patients (8%), and N2 in 4 (17%), all being PET/CT negative. PET/CT accuracy of T4 and N2/N3 compared to combined histological results of mediastinoscopy and EPP showed sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios of 78% and 50%, 100% and 75%, 100% and 50%, 94% and 75%, not applicable and 5.0, and 0.22 and 0.67, respectively. CONCLUSIONS: Non-curative surgery is avoided in 29% out of 42 MPM patients by preoperative PET/CT and in further 14% by mediastinoscopy. Even though both procedures are valuable, there are false negative findings with both, urging for even more accurate staging procedures. |
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Authors:
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Jens Benn Sørensen; Jesper Ravn; Annika Loft; Jørn Brenøe; Anne Kiil Berthelsen; |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Validation Studies Date: 2008-09-16 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 34 ISSN: 1873-734X ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-12-10 Completed Date: 2009-03-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 1090-6 Citation Subset: IM |
Affiliation:
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Department of Oncology, Finsen Centre/National University Hospital, Copenhagen, Denmark. jens.benn.soerensen@rh.regionh.dk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Fluorodeoxyglucose F18 / diagnostic use Humans Lung Neoplasms / pathology*, radiography, radionuclide imaging, surgery Lymphatic Metastasis Male Mediastinoscopy / methods* Mesothelioma / pathology*, radiography, radionuclide imaging, surgery Middle Aged Neoplasm Staging / methods* Pneumonectomy / methods Positron-Emission Tomography / methods* Predictive Value of Tests Radiopharmaceuticals / diagnostic use Sensitivity and Specificity Tomography, X-Ray Computed Unnecessary Procedures |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
| Investigator | |
Investigator/Affiliation:
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Ulf Aaseboe / ; Bo Billing / ; Thure Bjørck / ; Ola Brodin / ; Paal Brunsvig / ; Ulrica Forsløw / ; Hanna Frank / ; Olfred Hansen / ; Henrik Harving / ; Gunnar Hillerdal / ; Kari Dolven Jakobsen / ; Ake Johansson / ; Lars Ladegaard / ; Birgitta Lindh / ; Peter Melgaard / ; Niels Mygind / ; Tryggve Månsson / ; Torben Palshof / ; Stein Sundstrøm / ; Peter Sørensen / ; Tor Vigander / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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