| Regional nodal staging with (18)F-FDG PET-CT in non-small cell lung cancer: Additional diagnostic value of CT attenuation and dual-time-point imaging. | |
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MedLine Citation:
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PMID: 21511421 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: [Fluorine-18]-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET-CT) is widely performed in the regional nodal staging of non-small cell lung cancer (NSCLC). However, the uptake of (18)F-FDG by tubercular granulomatous tissues may lead to false-positive diagnosis. This is of special concern in China, where tubercular granulomatous disease is epidemic. Herein, we evaluated the efficacy of an additional CT attenuation and a dual-time-point scan in determining the status of lymph nodes. METHODS: Eighty NSCLC patients underwent curative surgical resection after (18)F-FDG PET-CT and separate breath-hold CT examinations. The initial images were analyzed by two methods. In method 1, nodal status was determined by (18)F-FDG uptake only. In Method 2, nodal status was determined by (18)F-FDG uptake associated with CT attenuation. For dual-time-point imaging, the retention index (RI) of benign and malignant nodal groups with positive uptake in the initial scan was examined. RESULTS: A total of 265 nodal groups were documented. On a per-nodal-group basis, the diagnostic sensitivity, specificity, and accuracy of Method 1 were 66.7%, 89.7%, and 85.3%, respectively, whereas those of Method 2 were 64.7%, 96.7%, and 90.6%, respectively. The improvement in diagnostic specificity and accuracy associated with the addition of CT attenuation in Method 2 as compared to Method 1 was statistically significant (p<0.01). Thirty-nine nodal groups with positive uptake in the initial scan underwent dual-time-point imaging and the difference in the RI between benign and malignant groups showed no statistical significance (p>0.05). CONCLUSION: (18)F-FDG PET-CT has high diagnostic value for preoperative lymph-node (N) staging of NSCLC patients. We show that (18)F-FDG uptake combined with CT attenuation improves the diagnostic specificity and accuracy of nodal diagnosis in NSCLC. For the lymph nodes with positive uptake in the initial scan, dual-time-point imaging has limited effect in differentiation. |
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Authors:
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Meng Li; Ning Wu; Ying Liu; Rong Zheng; Ying Liang; Wenjie Zhang; Ping Zhao |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-19 |
Journal Detail:
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Title: European journal of radiology Volume: - ISSN: 1872-7727 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106411 Medline TA: Eur J Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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