Stage T1 non-small cell lung cancer: Preoperative mediastinal nodal staging with integrated FDG PET/CT - A prospective study
Stage T1 non-small cell lung cancer: Preoperative mediastinal nodal staging with integrated FDG PET/CT - A prospective study
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DOI：
10.1148/radiol.2412051173
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发表时间：
2006-11-01
期刊：
影响因子：
19.7
通讯作者：
Kim, Seonwoo
中科院分区：
文献类型：
--
作者：
Kim, Byung-Tae;Lee, Kyung Soo;Kim, Seonwoo
目的：前瞻性评价综合氟18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和计算机断层扫描（CT） （PET/CT）术前诊断T1期非小细胞肺癌（NSCLC）纵隔淋巴结转移的敏感性和特异性，以手术和组织学结果为参考标准。材料和方法：获得机构审查委员会批准并知情同意。从2003年6月到2005年2月，150例T1期NSCLC患者（89例男性，61例女性，平均年龄59岁）接受了PET/CT综合分期和手术分期。两名观察员（一名放射科医生和一名核医学医生）通过分析PET（功能）和CT（解剖）图像对纵隔淋巴结进行前瞻性和一致性评估。以美国癌症分期联合委员会系统和手术及组织学结果作为参考标准确定淋巴结分期。恶性淋巴结的统计评估是按每个淋巴结站和每个人进行的。结果：共评估568个纵隔淋巴结站。150例患者中34例（23%）淋巴结为恶性，568个淋巴结站中55例（10%）淋巴结为恶性。对于恶性淋巴结的描述，综合PET/CT的敏感性、特异性、阳性预测值、阴性预测值和准确性在每个淋巴结站的基础上分别为42%（55 / 23）、100%（513 / 513）、100%（23 / 23）、94%（545 / 513）和94%(568 / 536)，在每个患者的基础上分别为47%（34 / 16）、100%（116 / 116）、100%（16 / 16）、87%（116 / 134）和88%（132 / 150）。结论：FDG PET/CT一体化对T1期NSCLC纵隔淋巴结分期具有较高的特异性和阳性预测价值，但敏感性较低。(c) RSNA， 2006年
Purpose: To prospectively evaluate the sensitivity and specificity of integrated fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) (PET/CT) for the preoperative diagnosis of mediastinal nodal metastasis in stage T1 non-small cell lung cancer (NSCLC), with surgical and histologic results as reference standards.Materials and Methods: Institutional review board approval and informed consent were obtained. From June 2003 to February 2005, 150 patients (89 men and 61 women; mean age, 59 years) with stage T1 NSCLC at stand-alone CT underwent integrated PET/CT and surgical staging. Two observers (one radiologist and one nuclear medicine physician) evaluated prospectively and in consensus the mediastinal nodes by analyzing both PET (functional) and CT (anatomic) images. Nodal stages were determined by using the American Joint Committee on Cancer staging system and surgical and histologic findings as the reference standard. Statistical evaluation of malignant lymph nodes was performed on per-nodal-station and per-person bases.Results: A total of 568 mediastinal nodal stations were evaluated. Nodes were positive for malignancy in 34 (23%) of 150 patients and 55 (10%) of 568 nodal stations. For depiction of malignant nodes, the respective sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated PET/CT were 42% (23 of 55), 100% (513 of 513), 100% (23 of 23), 94% (513 of 545), and 94% (536 of 568) on per-nodal-station basis and 47% (16 of 34), 100% (116 of 116), 100% (16 of 16), 87% (116 of 134), and 88% (132 of 150) on a per-patient basis.Conclusion: Integrated FDG PET/CT provides high specificity and positive predictive value of mediastinal nodal staging in stage T1 NSCLC, although the sensitivity is low. (c) RSNA, 2006