The role of 18F-FDG PET/CT for evaluation of metastatic mediastinal lymph nodes in patients with lung squamous-cell carcinoma or adenocarcinoma

Lu, Peiou; Sun, Ying; Sun, Yanqin; Yu, Lijuan

doi:10.1016/j.lungcan.2014.04.004

Cited by 36 publications

(34 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is worth considering that the present study was inadvertently subject to the same selective inclusion, although not to the same degree, and did not suffer corresponding losses in sensitivity. The present study does, however, agree with the previous studies [5,11,12] in the reduction of PPV, with preservation of NPV.…”

Section: Discussionsupporting

confidence: 87%

“…Using these additional criteria for interpretation of images on PET-CT improves diagnostic accuracy, even in a TB-endemic area. [5,11,12] Previous studies conducted in high TB-endemic areas did not demonstrate the anticipated reduction in specificity. In fact, these studies found a reduction in sensitivity.…”

Section: Discussionmentioning

confidence: 92%

“…In fact, these studies found a reduction in sensitivity. [5,11,12] These authors proposed that this may have been due to the selective inclusion of patients of lower clinical stage with possible micrometastases to lymph nodes that did not demonstrate positivity on PET-CT, as well as the designation of all calcified lymph nodes as benign. It is worth considering that the present study was inadvertently subject to the same selective inclusion, although not to the same degree, and did not suffer corresponding losses in sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…[2,5,9,10] The effect of TB on PET-CT staging of NSCLC has previously been investigated in areas with an incidence of TB of approximately 73/100 000 population. [5,11,12] Two studies from Korea showed that the sensitivity (75% and 46%, respectively) and PPV (27% and 72%) of PET-CT were adversely affected, but that a high specificity (85% and 98%) and NPV (98% in both studies) were maintained, especially when calcification and attenuation of nodes on CT was taken into account. [5,11] Recent data from China demonstrated a similar pattern of results, with a relatively low sensitivity (61.8% and 78.6% for adenocarcinoma and squamous cell carcinoma, respectively) and specificity (66.3% and 45.5%), and a high NPV (80.9% and 87%).…”

mentioning

confidence: 99%

“…The authors stated that the high incidence of granulomatous disease in their region impacted significantly on the rate of false-positive results in their study. [12] According to the World Health Organization, the incidence of TB in SA is 1 000/100 000 population. [13] To date, no study of the efficacy [14] were referred for PET-CT according to the standardised diagnostic algorithm that was used at the time of the study, with the PET-CT generally performed before tissue sampling (Fig.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Integrated positron emission tomography/computed tomography for evaluation of mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic area: A 5-year prospective observational study

et al. 2015

View full text Add to dashboard Cite

Background. Integrated positron emission tomography/computed tomography (PET-CT) is a well-validated modality for assessing mediastinal lymph node metastasis in non-small-cell lung cancer (NSCLC), which determines management and predicts survival. Tuberculosis (TB) is known to lead to false-positive PET-CT findings. Objectives. To assess the diagnostic accuracy of PET-CT in identifying mediastinal lymph node involvement of NSCLC in a high TB-endemic area. Methods. Patients who underwent both PET-CT and lymph node tissue sampling for the investigation of suspected NSCLC were prospectively included in this observational study. Results were analysed per patient and per lymph node stage. A post-hoc analysis was performed to test the validity of a maximum standardised uptake value (SUV max) cut-off for lymph node positivity. Results. PET-CT had a sensitivity of 92.6%, specificity of 48.6%, positive predictive value of 56.8% and negative predictive value (NPV) of 90.0% in the per-patient analysis. Diagnostic accuracy was 67.2%. Similar values were obtained in the per-lymph node stage analysis. TB was responsible for 21.1% of false-positive results. A SUVmax cut-off of 4.5 yielded an improvement in diagnostic accuracy from 64.0% to 84.7% compared with a cut-off of 2.5, but at the cost of decreasing the NPV from 90.6% to 83.5%. Conclusion. In a high TB-endemic area, PET-CT remains a valuable method for excluding mediastinal lymph node involvement in NSCLC. Patients with a negative PET-CT may proceed to definitive management without further invasive procedures. However, PET-CT-positive lymph nodes require pathological confirmation, and the possibility of TB must be considered.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Integrated positron emission tomography/computed tomography for evaluation of mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic area: A 5-year prospective observational study

et al. 2015

View full text Add to dashboard Cite

show abstract

Prognosis After Sublobar Resection of Small‐sized Non‐small Cell Lung Cancer with Visceral Pleural or Lymphovascular Invasion

2017

View full text Add to dashboard Cite

show abstract

Prognostic Factors of Pathological N1 Non‐small Cell Lung Cancer After Curative Resection Without Adjuvant Chemotherapy

et al. 2018

View full text Add to dashboard Cite

Background The aim of this study was to evaluate the outcomes of patients with pathological N1 non-small cell lung cancer who did not receive adjuvant chemotherapy. We attempted to identify those patients for whom adjuvant chemotherapy would be indispensable. Methods Among 132 patients who were diagnosed with pathological N1 lung cancer at a single institution from January 2010 to December 2016 were 32 patients who did not receive adjuvant treatment after curative surgical resection. The surgical and oncological outcomes of these patients were analyzed. Candidate factors for predicting recurrence were analyzed to identify patients at high risk of recurrence. Results The median follow-up time for all 32 patients was 1044 days. The 5-year recurrence-free survival (RFS) and disease-specific survival rates of the patients without adjuvant therapy were 50.3% and 77.6%, respectively. By multivariate analysis, tumors with a lepidic growth pattern [hazard ratio (HR) 0.119, p = 0.024] and extralobar lymph node metastasis (HR 6.848, p = 0.015) were significant factors predicting recurrence. The difference between the 5-year RFS rates of patients with tumors with or without a lepidic growth pattern was statistically significant (63.5% vs 40.0%, respectively; p = 0.050). The 5-year RFS rates of patients with intralobar lymph node metastasis versus those with extralobar lymph node metastasis were 63.3% and 18.8%, respectively (p = 0.002). Conclusions Patients with tumors without a lepidic growth pattern or with extralobar lymph node metastasis who do not receive adjuvant chemotherapy have a high recurrence rate after surgery. Therefore, these patients should be encouraged to undergo adjuvant chemotherapy if their overall condition is not a contraindication for chemotherapy.

show abstract

The role of 18F-FDG PET/CT for evaluation of metastatic mediastinal lymph nodes in patients with lung squamous-cell carcinoma or adenocarcinoma

Cited by 36 publications

References 22 publications

Integrated positron emission tomography/computed tomography for evaluation of mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic area: A 5-year prospective observational study

Integrated positron emission tomography/computed tomography for evaluation of mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic area: A 5-year prospective observational study

Prognosis After Sublobar Resection of Small‐sized Non‐small Cell Lung Cancer with Visceral Pleural or Lymphovascular Invasion

Prognostic Factors of Pathological N1 Non‐small Cell Lung Cancer After Curative Resection Without Adjuvant Chemotherapy

Contact Info

Product

Resources

About