Is FDG-PET/CT used correctly in the combined approach for nodal staging in NSCLC patients?
| Autor: | H Akyol, NC Yalcin, D Kuslu, Hakki Ulutas, R Koroglu, Aylin Comak, Tansel Ansal Balci, Ferhan Elmalı, Aysenur Akatli, Ersoy Kekilli, M Asik, FS Simsek |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Lung Neoplasms Biopsy Fine-Needle Nodal staging Standardized uptake value Multimodal Imaging Sensitivity and Specificity Endosonography Fluorodeoxyglucose F18 Carcinoma Non-Small-Cell Lung Positron Emission Tomography Computed Tomography medicine Humans Standardized Uptake Value Maximum Stage (cooking) Lymph node Aged Neoplasm Staging Retrospective Studies business.industry Mediastinum General Medicine Middle Aged medicine.disease Primary tumor Combined approach medicine.anatomical_structure Lymphatic Metastasis Female Fdg pet ct Lymph Nodes Radiopharmaceuticals Tomography X-Ray Computed Nuclear medicine business |
| Zdroj: | Nigerian Journal of Clinical Practice. 23:842 |
| ISSN: | 1119-3077 |
| Popis: | Background: The most widely accepted approach nowadays in nodal staging of non–small cell lung cancer (NSCLC) is the combined use of 18-Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). However, this approach may not be sufficient, especially for early stages. Aims: Our aim was to assess whether more satisfactory results can be obtained with standardized uptake value maximum lymph node/standardized uptake value mean mediastinal blood pool (SUVmax LN/SUVmean MBP), SUVmax LN/Primary tumor, or a novel cut-off value to SUVmax in this special group. Subjects and Methods: Patients with diagnosed NSCLC and underwent FDG-PET/CT were reviewed retrospectively. 168 LNs of 52 early stage NSCLC patients were evaluated. The LNs identified in surgery/pathology reports were found in the FDG-PET/CT images. Anatomic and metabolic parameters were measured. Statistical analysis was performed by using of MedCalc Statistical Software. Results: Regardless of LNs size; sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SUVmax >2.5 were 91.5%, 65.9%, 58.2%, and 95.1%, respectively. Optimum cut-off value of SUVmax was >4.0. Sensitivity, specificity, PPV, and NPV were found as 81.0%, 90.0%, 81.0%, and 90.0% respectively. Optimum cut-off value of SUVmax LN/SUVmean MBP was >1.71. Sensitivity, specificity, PPV, and NPV were found as 94.7%, 80.0%, 71.1%, and 96.7%, respectively. Optimum cut-off value of SUVmax LN/Primary tumor was >0.28. Sensitivity, specificity, PPV, and NPV were found as 81.1%, 85.1%, 72.9% and 90.1%, respectively. Conclusion: SUVmax LN/SUVmean MBP >1.71 has higher PPV than currently used, with similar NPV and sensitivity. This can provide increase in the accuracy of combined approach. In this way, faster nodal staging/treatment decisions, cost savings for healthcare system and time saving of medical professionals can be obtained. |
| Databáze: | OpenAIRE |
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