Document Detail


Value of positron emission tomography for lung cancer staging.
MedLine Citation:
PMID:  11869015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The therapeutic strategy in non-small-cell lung cancer (NSCLC) requires exact staging of tumour invasion (T) as well as differentiation between ipsi- and contralateral lymph node invasion (N1/2 vs N3). [18F]FDG-positron emission tomography (FDG-PET) has been shown to detect invaded N with high accuracy while correct determination of T appears to be unclear. The purpose of this prospective study was to evaluate benefit and necessity of 18FDG-PET as an additive to conventional staging modalities. METHODS: Forty patients with suspected non-small-cell lung cancer (NSCLC) were staged by means of computed tomography (CT), bronchoscopy, mediastinoscopy and bone scintigraphy. Additionally, attenuation corrected FDG-PET of the thorax was performed pre-operatively for analysis of T and N topography. After surgical resection with radical lymphadenectomy T and N staging results of CT and PET were compared with the pathological diagnoses. Specificity, sensitivity, positive predictive value and accuracy of CT and PET were calculated. RESULTS: Twenty three squamous cell carcinomas, 14 adenocarcinomas, and three non-malignant tumours were found. Accuracy of CT-T was 0.75 and of PET-T 0.78; accuracy of CT-N was 0.78 and of PET-N 0.80. By combination of CT-T and PET-T accuracy was 0.88. Combination of CT-N and PET-N yielded an accuracy of 0.90. In two out of three cases, PET correctly determined T0. In two cases non-malignant inflammatory lymph nodes were falsely staged as malignant by PET. CONCLUSIONS: Adequate pre-operative T- and N-staging is possible with both CT and FDG-PET. Accuracy can be improved by combination of CT and FDG-PET. FDG-PET is superior to CT in order to differentiate between malignant and benign tumours. However, acute inflammation can mimic malignant lymph node invasion. FDG-PET is justified as a supporting staging measure in cases presenting unclear differentiation between N2 and N3 after conventional staging and is helpful in cases with unclear cell type of the primary tumour.
Authors:
J M Albes; B M Dohmen; U Schott; E Schülen; M Wehrmann; G Ziemer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  28     ISSN:  0748-7983     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-28     Completed Date:  2002-03-12     Revised Date:  2007-07-02    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  55-62     Citation Subset:  IM    
Copyright Information:
Copyright Harcourt Publishers Limited.
Affiliation:
Division of Thoracic, Cardiac, and Vascular Surgery, University of Tübingen, Tübingen, Germany. johannes.albes@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Non-Small-Cell Lung / pathology,  radiography,  radionuclide imaging*
Fluorodeoxyglucose F18 / diagnostic use
Humans
Lung Neoplasms / pathology,  radiography,  radionuclide imaging*
Neoplasm Staging
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals / diagnostic use
Sensitivity and Specificity
Tomography, Emission-Computed*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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