Metastases from Non-Small Cell Lung Cancer: Mediastinal Staging in the 1990s—Meta-analytic Comparison Of PET and CT

Dwamena, Ben A.; Sonnad, Seema S.; Angobaldo, Jeff; Wahl, Richard L.

doi:10.1148/radiology.213.2.r99nv46530

Cited by 599 publications

(279 citation statements)

References 54 publications

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“…In a meta-analysis for mediastinal lymph node staging, the mean sensitivity and specificity were 85 and 95% for PET (accuracy = 92%) and 61 and 79% for CT (accuracy = 75%), respectively. The log odds ratios were 3.77 ± 0.51 for PET and 1.79 ± 0.15 for CT (p \ 0.001) [9]. The diagnostic ability of PET was similar in another meta-analysis in which the sensitivity and specificity were 88 and 92% for PET (accuracy = 91%) and 65 and 76% for CT (accuracy = 73%), respectively [10].…”

Section: Discussionmentioning

confidence: 69%

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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: 69%

“…Both PET and integrated PET/CT have shown higher accuracy in lymph node staging of lung cancer than conventional CT [5,[9][10][11][12][13]. However, 18 F-FDG is not tumor-specific, therefore, it can be taken up by various physiologic changes or benign pathologic lesions [14].…”

Section: Introductionmentioning

confidence: 99%

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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“…PET is more accurate than CT in the detection or exclusion of mediastinal nodal metastases: sensitivities are 67-100% and 50-63% respectively whilst specificities are 81-100% and 59-94% [62][63][64][65]. PET has been shown to correctly increase or decrease nodal staging as initially determined by CT in 21% of presurgical patients [66].…”

Section: Positron Emission Tomographymentioning

confidence: 98%

Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

114

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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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“…PET/CT should be used for RT planning in NSCLC because it more accurately images tumor extent than CT alone [73], This is proven by a large surgical literature on the accuracy of FDG-PET in the lymph node staging of NSCLC [10,68,74,75].…”

Section: Tumor Movementmentioning

confidence: 99%

Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006–2007

MacManus

Nestle

Rosenzweig

et al. 2009

Radiotherapy and Oncology

331

197

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Metastases from Non-Small Cell Lung Cancer: Mediastinal Staging in the 1990s—Meta-analytic Comparison Of PET and CT

Abstract: PET is superior to CT for mediastinal staging of non-small cell lung cancer, independent of performance index or clinical context of PET imaging.

Cited by 599 publications

References 54 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

Diagnostic imaging of lung cancer

Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006–2007

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