Mediastinal lymph node size in lung cancer

Libshitz, HI; McKenna, RJ

doi:10.2214/ajr.143.4.715

Cited by 90 publications

(30 citation statements)

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“…Using morphological imaging (CT and MR), the probability of mediastinal metastases increases with lymph node size. However, over one-third of lymph nodes that are 2-4 cm in small-axis diameter are hyperplastic and do not contain metastases [21,22]. For these reasons, mediastinoscopy is often required to better clarify the clinical staging of the disease in the mediastinum.…”

Section: Discussionmentioning

confidence: 99%

Staging of the mediastinum: value of positron emission tomography imaging in non-small cell lung cancer

Bury¹,

Paulus²,

Dowlati³

et al. 1996

Eur Respir J

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S St ta ag gi in ng g o of f t th he e m me ed di ia as st ti in nu um m: : v va al lu ue e o of f p po os si it tr ro on n e em mi is ss si io on n t to om mo og gr ra a--p ph hy y i im ma ag gi in ng g i in n n no on n--s sm ma al ll l c ce el ll l l lu un ng g c ca an nc ce er r We have performed a prospective study comparing FDG-PET and CT of the thorax in the presurgical assessment of the mediastinum in 50 patients with newly diagnosed non-small cell lung cancer (NSCLC). CT and PET scans were interpreted separately, and results were compared to pathological staging obtained during thoracotomy.Hilar or mediastinal lymph node involvement was present in 58%. In staging for lymph node involvement, CT had a sensitivity of 72% and specificity of 81%, whereas PET had a sensitivity and specificity of 90% and 86%, respectively. When the PET study was compared to histological results, there were four cases showing more advanced mediastinal involvement with PET and four cases showing less involvement with PET.From our preliminary results, we conclude that positron emission tomography with 18-fluorodeoxyglucose is significantly more accurate than computed tomography in the mediastinal staging of non-small cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Staging of the mediastinum: value of positron emission tomography imaging in non-small cell lung cancer

Bury¹,

Paulus²,

Dowlati³

et al. 1996

Eur Respir J

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“…In 1984, LIBSHITZ and MCKENNA [105] demonstrated CT sensitivity and specificity of 67% and 66% respectively using a nodal size of 1 cm to distinguish between benign nodes and those seeded with metastases. In 1988 STAPLES et al [106] demonstrated 79% sensitivity and 65% specificity for CT using a 1-cm long axis nodal cut-off measurement.…”

Section: Nodal Statusmentioning

confidence: 99%

“…However, in 1992 MCLOUD et al [108] using a nodal short axis measurement of 1 cm in 143 patients, returned to less inspiring figures of 64% sensitivity and 62% specificity, respectively. These studies [105,106,108] all examined patients with presumed operable lung cancer in whom complete nodal sampling was performed either at mediastinoscopy or thoracotomy. Both LIBSHITZ and MCKENNA [105] and MCLOUD et al [108] observed an increase in false-positive nodes in patients with obstructive pneumonia.…”

Section: Nodal Statusmentioning

confidence: 99%

“…These studies [105,106,108] all examined patients with presumed operable lung cancer in whom complete nodal sampling was performed either at mediastinoscopy or thoracotomy. Both LIBSHITZ and MCKENNA [105] and MCLOUD et al [108] observed an increase in false-positive nodes in patients with obstructive pneumonia. MCLOUD et al [103] also found that 37% of nodes, which were 2-3 cm in diameter, did not contain metastases at thoracotomy.…”

Section: Nodal Statusmentioning

confidence: 99%

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Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

121

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Carcinoma of the bronchus is the most common malignancy in the Western world. It is also the leading cause of cancer-related death accounting for 32% of all cancer deaths in males and 25% in females [1]. In the USA it causes more deaths than cancers of the colon, breast and prostate combined [2]. Disappointingly, in a recent UK survey of improvements in cancer survival [3], carcinoma of the bronchus showed the smallest percentage reduction in the number of deaths avoided between 1981-1990 (0.2%). This compares badly with breast (11% reduction) and melanoma (32%). The overall 5-yr survival for lung cancer diagnosed between 1986-1990 was only 5.3% (against 66% for breast and 76% for melanoma). It is on this background that the radiologist remains actively employed in the detection, diagnosis, staging and review of this common malignancy.

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“…Although the detection of enlarged (at CT, short axis >10 mm) or fluorodeoxyglucose (FDG)-avid mediastinal lymph nodes at PET increases the probability of malignant involvement [4,5], nevertheless the accuracy of radiological imaging in mediastinal staging is suboptimal [6][7][8]. Therefore, additional mediastinal tissue staging is frequently required to confirm or exclude metastatic mediastinal nodal involvement.…”

Section: Introductionmentioning

confidence: 99%