TY - JOUR
T1 - The role of integrated positron emission tomography and computed tomography in the assessment of nodal spread in cases with non-small cell lung cancer
AU - Tasci, Erdal
AU - Tezel, Cagatay
AU - Orki, Alpay
AU - Akin, Oral
AU - Falay, Okan
AU - Kutlu, Cemal Asim
PY - 2010
Y1 - 2010
N2 - Integrated positron emission tomography and computed tomography (PET/CT) scanning has become the standard for oncologic imaging. We sought to determine the role of PET/CT in mediastinal non-small cell lung cancer staging. One hundred and twenty-seven consecutive patients were enrolled in the study where PET/CT was performed due to pathologically defined non-small cell carcinoma from a single center. They all underwent complete resection with a thoracotomy and systemic lymph node dissection (SLND) between October 2005 and January 2007. Postoperative pathology results of lymph node stations regarding the nodal spread and stage were compared with clinical stage obtained by PET/CT. The sensitivity, specificity, accuracy, negative predictive value (NPV) and positive predictive value (PPV) of PET/CT in N2 cases were determined to be 72.0%, 94.4%, 92.7%, 97.7% and 49.2%, respectively. Maximum standard uptake (SUV max) cut-off value for mediastinal N2 involvement in PET/CT was obtained by applying 'receiver operating characteristic' (ROC) analysis that was set to 5.2. Correct stage with PET/CT was established in 76.3% of cases. Staging of non-small cell lung cancer (NSCLC), according to the PET/CT for which we determined 97.79% NPV, we consider that thoracotomy without preoperative mediastinal invasive staging in cases of negative mediastinal involvement in PET/CT can be certainly performed.
AB - Integrated positron emission tomography and computed tomography (PET/CT) scanning has become the standard for oncologic imaging. We sought to determine the role of PET/CT in mediastinal non-small cell lung cancer staging. One hundred and twenty-seven consecutive patients were enrolled in the study where PET/CT was performed due to pathologically defined non-small cell carcinoma from a single center. They all underwent complete resection with a thoracotomy and systemic lymph node dissection (SLND) between October 2005 and January 2007. Postoperative pathology results of lymph node stations regarding the nodal spread and stage were compared with clinical stage obtained by PET/CT. The sensitivity, specificity, accuracy, negative predictive value (NPV) and positive predictive value (PPV) of PET/CT in N2 cases were determined to be 72.0%, 94.4%, 92.7%, 97.7% and 49.2%, respectively. Maximum standard uptake (SUV max) cut-off value for mediastinal N2 involvement in PET/CT was obtained by applying 'receiver operating characteristic' (ROC) analysis that was set to 5.2. Correct stage with PET/CT was established in 76.3% of cases. Staging of non-small cell lung cancer (NSCLC), according to the PET/CT for which we determined 97.79% NPV, we consider that thoracotomy without preoperative mediastinal invasive staging in cases of negative mediastinal involvement in PET/CT can be certainly performed.
KW - Mediastinal lymph nodes
KW - Positron emission tomography
KW - Preoperative evaluation
UR - http://www.scopus.com/inward/record.url?scp=75449115020&partnerID=8YFLogxK
U2 - 10.1510/icvts.2009.220392
DO - 10.1510/icvts.2009.220392
M3 - Article
C2 - 19933240
AN - SCOPUS:75449115020
SN - 1569-9293
VL - 10
SP - 200
EP - 203
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 2
ER -