| Value of positron emission tomography for lung cancer staging. | |
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MedLine Citation:
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PMID: 11869015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J M Albes; B M Dohmen; U Schott; E Schülen; M Wehrmann; G Ziemer |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2002-02-28 Completed Date: 2002-03-12 Revised Date: 2007-07-02 |
Medline Journal Info:
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Nlm Unique ID: 8504356 Medline TA: Eur J Surg Oncol Country: England |
Other Details:
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Languages: eng Pagination: 55-62 Citation Subset: IM |
Copyright Information:
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Copyright Harcourt Publishers Limited. |
Affiliation:
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Division of Thoracic, Cardiac, and Vascular Surgery, University of Tübingen, Tübingen, Germany. johannes.albes@med.uni-jena.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Carcinoma, Non-Small-Cell Lung
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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:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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