Standardized visual reading of F18-FDG-PET in patients with non-small cell lung cancer scheduled for preoperative thoracic lymph node staging

Rogasch, J; Apostolova, Ivayla; Steffen, Ingo G.; Steinkrüger, Ferdinand L. G. A.; Genseke, Philipp; Riedel, Sandra; Wertzel, H; Achenbach, H. Jost; Kalinski, Thomas; Schultz, Meinald; Schreiber, Jens; Amthauer, Holger; Furth, Christian

doi:10.1016/j.ejrad.2016.05.004

Cited by 12 publications

(19 citation statements)

References 22 publications

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“…The preoperative prediction of cOLNM comprises invasive and noninvasive methods. Noninvasive methods, such as CT and 18F fluorodeoxyglucose positron emission tomography combined with computed tomography (18FDG-PET/CT), 10 , 11 play an indispensable role in pretreatment evaluation. Despite improving the accuracy of staging, CT and PET/CT still have defects due to their relatively low resolution.…”

Section: Introductionmentioning

confidence: 99%

A Radiomics Nomogram for Preoperative Prediction of Clinical Occult Lymph Node Metastasis in cT1-2N0M0 Solid Lung Adenocarcinoma

Zhang

Ran-ran

Luan

et al. 2021

CMAR

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Section: Introductionmentioning

confidence: 99%

A Radiomics Nomogram for Preoperative Prediction of Clinical Occult Lymph Node Metastasis in cT1-2N0M0 Solid Lung Adenocarcinoma

Zhang

Ran-ran

Luan

et al. 2021

CMAR

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“…First, we adopted a fixed SUV window thresholds for PET images reading to reduce observer variability. The upper SUV window threshold was set at 5 because it was about double the SUVmean value of the liver, which was suggested for PET reading [ 26 ], in our PET/CT scanner. According to our experience, pathologic and physiological FDG uptake can be reasonably illustrated by this setting.…”

Section: Discussionmentioning

confidence: 99%

Measuring distance from the incisors to the esophageal cancer by FDG PET/CT: endoscopy as the reference

Hsu

Chang

et al. 2022

BMC Gastroenterol

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Background Using endoscopy as the reference, this study evaluated the accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in measuring distance from the incisors to the PET detectable esophageal cancer. If there is high concordance between endoscopic and PET measurements, our results may provide a basis to use FDG PET/CT in cooperation with endoscopic measurement to localize those PET/CT and CT undetectable esophageal tumors for radiotherapy planning. Materials Esophageal cancer patients with pretreatment endoscopy and FDG PET/CT detectable esophageal tumors were recruited retrospectively. The distances from the incisors to the proximal esophageal tumor margins were determined by endoscopy and by the sagittal images of FDG PET/CT. The endoscopic measurement was used as the comparative reference. A nuclear medicine doctor and a radiation oncologist each performed the FDG PET/CT measurement twice for every patient. We analyzed the differences in these measurements, and assessed agreement and reproducibility of the results by the intraclass correlation coefficient (ICC). Results Thirty-four patients, with 35 esophageal tumors, were included. By endoscopy and FDG PET/CT, the mean distances from the incisors to the proximal esophageal tumor margin were 27.3 ± 6.4 cm (range 17.1–40.0 cm) and 26.8 ± 6.3 cm (range 15.7–41.3 cm), respectively. The mean absolute differences between the endoscopic and four FDG PET/CT measurements ranged from 1.129 to 1.289 cm (SD: 0.98–1.19). The measurement agreement between FDG PET/CT and endoscopy by ICC was between 0.962 and 0.971. The intra- and interobserver reproducibilities of the two readers were excellent (intraobserver ICC: 0.985, 0.996; interobserver ICC: 0.976–0.984). Conclusions FDG PET/CT was in high agreement with endoscopy in measuring the distance from the incisors to the proximal esophageal tumor margin. For FDG PET/CT and CT undetectable esophageal cancer, incorporation of the endoscopic measurement with PET/CT might be a way for making radiotherapy plan.

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“…17 The mean 18 A five-point visual score of LNs was used, with a standardised lower threshold set at 0 and the upper threshold at 2 times the liver's mean standardised uptake value (SUV mean ). 14 The LNs were rated based on the maximum intensity projection image with grey scale images (Figure 1):…”

Section: Technical Aspectsmentioning

confidence: 99%

“…[8][9][10][11] Both semiquantitative assessment and qualitative visual interpretation are recommended for distinguishing benign from malignant lymph nodes (LNs). [10][11][12][13][14] In a semiquantitative approach, the maximum standardised uptake value (SUV max ) is used. [10][11][12] Yet, SUV max depends on many physiological as well as technical factors, such as injection time, uptake period, and blood glucose level.…”

Section: Introductionmentioning

confidence: 99%

“…Studies have compared the accuracies of simple SUV max and visual score generated by different comparisons with the activity in the aorta and other locations, as well as with a simple unified windowing technique. 13,14 We aimed to evaluate the performance of 18 F-FDG PET/CT on mediastinal/extramediastinal nodal staging of NSCLC based on SUV max , visual score, and nodal diameter. The disparity between radiological and pathological staging was also reviewed.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Accuracy of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Preoperative Mediastinal/Extramediastinal Nodal Staging of Non–Small-Cell Lung Carcinoma

Chu

et al. 2023

Hong Kong Journal of Radiology

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Introduction: Lung cancer has the highest incidence and mortality among malignancies in many countries. 18 F-Fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is commonly indicated for the preoperative nodal staging of non-small-cell lung carcinoma. While maximum standardised uptake value (SUV max ), visual scoring systems and nodal diameter have been proposed to distinguish benign from malignant nodes, studies comparing the different measurements have been limited. Correct nodal staging is crucial in determining if treatment intent is curative or palliative. This study aimed to evaluate the accuracies of nodal staging in 18 F-FDG PET/CT based on different methods. Methods: A total of 467 mediastinal/extramediastinal lymph nodes from 97 patients, who underwent staging 18 F-FDG PET/CT at our centre for non-small-cell lung carcinoma, were retrospectively reviewed. The nodes were evaluated based on SUV max , five-point visual interpretation score, and diameter. Their sensitivities, specificities and accuracies were compared with histology using receiver operating characteristics curves and areas under the curves (AUCs). Subgroup analyses based on T staging, histology, epidermal growth factor receptor (EGFR) status, lymph node locations, and tumour SUV max were also investigated. Results:The diagnostic performance of visual score (at optimal cut-off of 3) yielded the highest specificity (0.932), accuracy (0.916), positive predictive value (0.623), and negative predictive value (0.972), results of which were similar to SUV max of 2.5 and better than nodal diameter of 10 mm. Subgroup analyses showed that visual interpretation achieved satisfactory AUCs in different T stages, histologies, EGFR statuses, locations of lymph nodes, and tumour SUVs max . Conclusion:The five-point visual interpretation is a convenient diagnostic tool with performance better than nodal diameter, and similar to that of SUV max .

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Standardized visual reading of F18-FDG-PET in patients with non-small cell lung cancer scheduled for preoperative thoracic lymph node staging

Cited by 12 publications

References 22 publications

A Radiomics Nomogram for Preoperative Prediction of Clinical Occult Lymph Node Metastasis in cT1-2N0M0 Solid Lung Adenocarcinoma

A Radiomics Nomogram for Preoperative Prediction of Clinical Occult Lymph Node Metastasis in cT1-2N0M0 Solid Lung Adenocarcinoma

Measuring distance from the incisors to the esophageal cancer by FDG PET/CT: endoscopy as the reference

Diagnostic Accuracy of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Preoperative Mediastinal/Extramediastinal Nodal Staging of Non–Small-Cell Lung Carcinoma

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