FDG-PET imaging for lymph node staging and pathologic tumor response after neoadjuvant treatment of non-small cell lung cancer.
FDG-PET imaging for lymph node staging and pathologic tumor response after neoadjuvant treatment of non-small cell lung cancer.
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发表时间：
2006-04
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通讯作者：
T. Ohtsuka;H. Nomori;A. Ebihara;Kenichi Watanabe;M. Kaji;T. Naruke;K. Suemasu;K. Uno
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作者：
T. Ohtsuka;H. Nomori;A. Ebihara;Kenichi Watanabe;M. Kaji;T. Naruke;K. Suemasu;K. Uno
目的多项研究表明，18F-脱氧葡萄糖正电子发射断层扫描(FDG-PET)对肺癌的分期是有效的。然而，FDG-PET对肺癌新辅助治疗后分期的疗效仍存在争议。这项研究比较了FDG-PET和CT在肺癌分期中的作用，并评估了这两种方法预测原发肿瘤对新辅助治疗的病理反应的能力。患者和方法对22例接受新辅助治疗后再手术的患者进行调查。18名患者接受了放化疗，4名患者只接受了化疗。对22例患者的103个淋巴结站进行FDGPET和CT检查。比较15例接受FDG-PET和CT检查的患者新辅助治疗前后肿瘤的FDG摄取和肿瘤大小。结果FDG-PET和CT预测残存肿瘤的能力无显著差异。纵隔淋巴结FDG-PET的阳性预测值(0.29)低于CT(0.64)(p=0.04)，但FDG-PET和CT对其他淋巴结的阳性预测值差异无统计学意义。在15例患者中，新辅助治疗后FDG摄取的减少和CT显示的肿瘤大小的缩小都与病理反应显著相关(分别为p=0.003和0.009)。结论FDG-PET在非小细胞肺癌新辅助治疗后的淋巴结分期或预测病理反应方面并不比CT有任何优势。
PURPOSE A number of studies have demonstrated that 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is effective for staging of lung cancer. However, the efficacy of FDG-PET for staging lung cancer after neoadjuvant treatment is still controversial. This study compared FDG-PET and computed tomography (CT) for lung cancer staging, and evaluated the ability of the two methods to predict the pathologic response of the primary tumor to neoadjuvant treatment. PATIENTS AND METHODS Twenty-two patients who underwent neoadjuvant treatment followed by surgery were investigated. Eighteen patients received chemoradiotherapy and four patients received chemotherapy only. One hundred and three lymph node stations in the 22 patients were evaluated by FDG-PET and CT. The pathologic responses of the tumors were compared by FDG-uptake and tumor size on CT for the 15 patients who underwent FDG-PET and CT both before and after neoadjuvant treatment. RESULTS There was no significant difference in the ability of FDG-PET or CT to predict residual viable tumor. Although positive predictive value by FDG-PET (0.29) was lower than that by CT (0.64) (p=0.04) in the mediastinal lymph nodes, there were no statistically significant differences in the other results of lymph nodes by FDG-PET and CT. Both decrease in FDG-uptake and decrease in tumor size by CT after neoadjuvant treatment correlated significantly with pathologic response in the 15 patients (p=0.003 and 0.009, respectively). CONCLUSION FDG-PET did not appear to offer any advantages over CT for lymph node staging or for predicting the pathologic response after neoadjuvant treatment of non-small cell lung cancer.