Document Detail


The effectiveness of 18F-FDG PET/CT combined with STIR MRI for diagnosing nodal involvement in the thorax.
MedLine Citation:
PMID:  19091887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to compare the efficacy of short-tau inversion-recovery (STIR) MRI and 18F-FDG PET/CT for the detection of metastasis in mediastinal and hilar lymph nodes in patients with lung cancer. METHODS: Ninety-three patients with known or suspected lung cancer with mediastinal and hilar lymph node swelling underwent STIR MRI and 18F-FDG PET/CT examinations. STIR MRI scans were obtained with a 2% copper sulfate phantom placed along the back of each patient, with the lymph node-to-phantom ratio calculated for quantitative analysis. For qualitative analysis, the results of all STIR MRI scans were evaluated using a 5-point visual scoring system. To evaluate the diagnostic capabilities of STIR MRI and 18F-FDG PET/CT, we used receiver-operating-characteristic curve analysis to determine the optimal thresholds for the lymph node-to-phantom ratio, visual score, and maximal standardized uptake value. Further, the capability of each to determine N-stage was compared in each patient using the McNemar test. RESULTS: A total of 137 lymph nodes (82 malignant lesions, 55 benign lesions) were analyzed. When optimal threshold values were adopted, the quantitative and qualitative sensitivity, specificity, and accuracy of STIR MRI were not significantly different from those of 18F-FDG PET/CT. However, 18F-FDG PET/CT in combination with qualitative STIR MRI analysis had a significantly higher capability to detect nodal involvement on an individual-patient basis (96.9% specificity, 90.3% accuracy) than did 18F-FDG PET/CT alone (65.6% specificity, 81.7% accuracy). CONCLUSION: We found that the diagnostic capability of STIR MRI was not significantly different from that of 18F-FDG PET/CT. However, when those methods were combined, the diagnostic capability for N-staging was significantly improved.
Authors:
Miwa Morikawa; Yoshiki Demura; Takeshi Ishizaki; Shingo Ameshima; Isamu Miyamori; Masato Sasaki; Tatsuro Tsuchida; Hirohiko Kimura; Yasuhisa Fujibayashi; Hidehiko Okazawa
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-17
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  50     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  IM    
Affiliation:
Department of Respiratory Medicine, University of Fukui, Fukui, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Lung Neoplasms / pathology*,  radiography,  radionuclide imaging
Lymphatic Metastasis / pathology,  radiography*,  radionuclide imaging*
Magnetic Resonance Imaging
Male
Mediastinal Neoplasms / radiography,  radionuclide imaging,  secondary
Middle Aged
Neoplasm Staging
Phantoms, Imaging
Positron-Emission Tomography
Radiography, Thoracic*
Sensitivity and Specificity
Thorax / pathology*,  radionuclide imaging
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

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


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