18F-FDG PET for the lymph node staging of non-small cell lung cancer in a tuberculosis-endemic country: Is dual time point imaging worth the effort?

Yen, Ruoh‐Fang; Chen, Ke-Cheng; Lee, Jang-Ming; Chang, Yeun‐Chung; Wang, Jane; Cheng, Mei‐Fang; Wu, Yen‐Wen; Lee, Yung-Chie

doi:10.1007/s00259-008-0733-1

Cited by 67 publications

(86 citation statements)

References 28 publications

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“…It is quite possible that patients with inflammatory lung disease had more false-positive lymph nodes with low to intermediate 18 F-FDG uptake and, thus, a higher-than-usual SUV was obtained for the highest accuracy. A visual interpretation is widely used for clinical PET interpretation of lymph node involvement [25][26][27][28][29][30][31]. Most of the previous comparative studies demonstrated that visual analysis of PET is superior or comparable to the semiquantitative method except for N3 lymph nodes [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…A visual interpretation is widely used for clinical PET interpretation of lymph node involvement [25][26][27][28][29][30][31]. Most of the previous comparative studies demonstrated that visual analysis of PET is superior or comparable to the semiquantitative method except for N3 lymph nodes [25][26][27][28][29]. On the other hand, according to our results, the diagnostic performance of the visual criterion ''localized FDG uptake'' was inferior to a semiquantitative criterion, SUVmax (p = 0.002 for N1-N3 and 0.001 for N1-N2).…”

Section: Discussionmentioning

confidence: 99%

“…A newly employed method for discrimination of metastasis from inflammatory lesion was dual-time-point PET imaging, which was initially applied to detect primary mass of malignancies [28,[32][33][34]. Dual-time-point imaging increased the sensitivity and accuracy of 18 F-FDG PET, and a percent change of SUV was specific for malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Dual-time-point imaging increased the sensitivity and accuracy of 18 F-FDG PET, and a percent change of SUV was specific for malignancy. Similarly, dual-time-point imaging also increased the sensitivity and accuracy of PET in detecting primary lung cancer [32] and also was tried in lymph node staging of non-small-cell lung cancer [28]. However, the retention index was not significantly different between metastatic and benign lymph nodes and thus did not enhance the diagnostic accuracy of visual analysis.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Sun

Park

et al. 2008

Lung

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As 18 F-fluorodeoxyglucose (FDG) is taken up by inflammatory lymph nodes, it could be falsely interpreted as metastasis. Therefore, we evaluated the diagnostic ability of positron emission tomography/computed tomography (PET/CT) for lymph node staging of lung cancer when inflammatory lung disease coexisted. Patients with operable non-small-cell lung cancer and FDG-avid lymph nodes were retrospectively classified into two groups; those with inflammatory lung disease (ILD) and those without it (NILD). Receiver operating characteristic (ROC) curve analysis was performed for maximum standardized uptake value (SUVmax), pattern of FDG uptake, maximum Hounsfield unit, and size, and then the areas under the ROC curves (AUCs) were compared between subgroups. There were 124 patients (ILD/ NILD = 38/86) and 396 FDG-avid lymph nodes (ILD/ NILD = 140/256). The average number of FDG-avid lymph nodes was greater in ILD (3.7 vs. 2.9, p = 0.039), whereas the proportion of metastasis was higher in NILD (25.4% vs. 11.4%, p = 0.002). With all N1-N3 lymph nodes and the NILD group, the AUC values of all four parameters were significantly greater than 0.5 (p \ 0.05), and SUVmax was the most valuable parameter for lymph node metastasis. However, in the ILD group, only the AUC value of SUVmax was significantly greater than 0.5. These results were reproduced when analyses were performed with N1-N2 lymph nodes. In conclusion, SUVmax was the most valuable PET/CT parameter for assessment of lymph node metastasis in patients with operable non-small-cell lung cancer. In addition, it was the only valuable parameter when inflammatory lung disease coexisted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Sun

Park

et al. 2008

Lung

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“…Moreover, in several studies, it has been proposed that dual-time-point (DTP) FDG PET/ CT may improve the accuracy of LN staging in NSCLC [6][7][8]. However, other studies reported that single-timepoint (STP) FDG PET/CT at 1 h after FDG injection was sufficiently useful for LN staging in NSCLC, and the usefulness of DTP PET/CT is still controversial [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Dual-time-point FDG PET/CT: Is It Useful for Lymph Node Staging in Patients with Non-Small-Cell Lung Cancer?

Kim

2012

Nucl Med Mol Imaging

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Purpose Dual-time-point (DTP) FDG PET/CT has been shown to be useful for lymph node (LN) staging in patients with non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the LN staging ability of DTP FDG PET/CT in the predominant area of pulmonary tuberculosis. Methods Sixty-nine NSCLC patients underwent DTP PET/ CT. Regions of interest were placed on each LN of each station, and the maximum SUVs were measured. Three variables were obtained: (1) the SUV on the early scan (SUV early ), (2) the SUV on the delayed scan (SUV delayed ), and (3) the retention index of the SUV (RI). Each patient had one final LN stage and three other LN stages according to the cutoff values of SUV early , SUV delayed , and RI. Results In the LN-based analysis, the area under the ROC curve of SUV delayed (0.884) was significantly larger (P< 0.01) than those of SUV early (0.868) and RI (0.717). Among the three variables, SUV delayed was more accurate (P<0.01) for detecting the mediastinal LN metastasis than SUV early and RI. In the patient-based analysis, SUV delayed had correctly determined LN stages in 55 of 69 patients (sensitivity, specificity, and accuracy088.7 %, 50.0 %, and 79.7 %), whereas SUV early and RI correctly determined LN stages in 53 and 52 patients, respectively. Conclusions In this study, comparing the diagnostic efficacy of SUV early , SUV delayed , and RI for LN staging in patients with NSCLC, SUV delayed was the most accurate variable for LN staging. DTP PET/CT could provide improved diagnostic accuracy for the LN staging of NSCLC.

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FDG PET/CT in TB: Mimics, Pitfalls, and Limitations

Šaranović

Stojiljković

2020

PET/CT in Tuberculosis

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18F-FDG PET for the lymph node staging of non-small cell lung cancer in a tuberculosis-endemic country: Is dual time point imaging worth the effort?

Abstract: Our study demonstrates that PET is more accurate than CECT in LN staging NSCLC patients in Taiwan where TB is still prevalent. Semi-quantitative SUV method or DTPI with RI does not result in better diagnostic accuracy than visual analysis of PET images.

Cited by 67 publications

References 28 publications

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Dual-time-point FDG PET/CT: Is It Useful for Lymph Node Staging in Patients with Non-Small-Cell Lung Cancer?

FDG PET/CT in TB: Mimics, Pitfalls, and Limitations

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