| Targeted lymph node biopsy in mediastinoscopy using 3D FDG-PET/CT movies: a feasibility study. | |
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MedLine Citation:
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PMID: 22311052 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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In non-small-cell lung cancer, positive lymph nodes with increased fluorodeoxyglucose (FDG) uptake may be missed by mediastinoscopy. Lack of pathological confirmation may lead to radical, but unnecessary lung surgery. To minimize these false-negative results, the feasibility and potential value of three-dimensional (3D) FDG-PET/computed tomography (CT) movies were investigated to improve targeted lymph node biopsy during mediastinoscopies. PET/CT images were rendered in 3D volumes with multiplanar reconstructions and maximum intensity projections and reviewed in 3D 'fly-through' and 'fly-around' movies. These movies were developed and optimized by the Departments of Surgery and Nuclear Medicine. Twenty-two consecutive patients with non-small-cell lung cancer were included, of whom eight were FDG-PET positive for mediastinal lymph nodes. 3D FDG-PET/CT movies were presented to surgeons before mediastinoscopy. Surgical consequences were investigated, including sensitivity and the negative predictive value of mediastinoscopy. Results were compared with those of a retrospective study in which 3D techniques were not used. During mediastinoscopies, the 3D-PET/CT movies were found to be helpful in the surgical localization of FDG-positive lymph nodes. It led to more confidence in the surgical approach. The sensitivity and negative predictive value were 86 and 94%, respectively. Although not statistically significant, these results were higher compared with those of the retrospective study (75 and 92%, respectively). 3D FDG-PET/CT guidance during mediastinoscopy is feasible. The movies seem to lead to targeted biopsy of lymph nodes. They may reduce false-negative mediastinoscopies and improve staging of lung cancer. 3D FDG-PET/CT can be seen as a promising tool for further implementation of image-guided surgery. |
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Authors:
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Françoise J Siepel; Wieger I de Bruin; Eino B van Duyn; Pascal Steenvoorde; Nils R L Wagenaar; Cornelis H Slump; Jorn A van Dalen |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-5 |
Journal Detail:
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Title: Nuclear medicine communications Volume: - ISSN: 1473-5628 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8201017 Medline TA: Nucl Med Commun Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Departments of aNuclear Medicine bSurgery, Medisch Spectrum Twente cInstitute for Technical Medicine, University of Twente, Enschede Departments of dNuclear Medicine eClinical Physics, Ziekenhuisgroep Twente, Hengelo, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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