Multidisciplinary Postoperative Validation of 18F-FDG PET/CT Scan in Nodal Staging of Resected Non-Small Cell Lung Cancer

Abstract

Background: The aim of this study was to examine the validity of PET/CT scans in the preoperative identification of lymph node metastases (LNM) and compare them with postoperative outcomes. Methods: In this retrospective study, we included 87 patients with a solitary lung nodule or biopsy-proven non-small cell lung cancer treated in our institution from 2009 to 2015. Patients were divided into two groups and four subgroups, depending on pre- and postoperative findings. Results: According to our analysis, PET/CT scan has a sensitivity of 50%, a specificity of 88.89%, a positive predictive value of 63.16%, and a negative predictive value of 82.35%. Among the patients, 13.8% were downstaged in PET-CT, while 8% were upstaged. In 78.2% of cases, the PET/CT evaluation was consistent with the histology. Metastases without extracapsular invasion were seldom recognized on PET/CT. Conclusions: This analysis showed the significance of extracapsular tumor invasion, which causes an inflammatory reaction, on LNM, which is probably responsible for preoperative false-positive findings. In conclusion, PET/CT scans are very effective in identifying patients without tumors. Furthermore, it is highly probable that patients with negative findings are free of disease.

Association between cigarette smoking history, metabolic phenotypes, and EGFR mutation status in patients with non-small cell lung cancer

“…Positron emission tomography/computed tomography (PET/CT) with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG), a molecular imaging modality, has been widely used in clinical diagnosis, staging, response evaluation, and prognosis of lung cancer ( 15 - 17 ). Several metabolic parameters, including maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), could reflect the metabolic activity of 18 F-FDG ( 18 , 19 ).…”

Next-Generation Lung Cancer Surgery: A Brief Trip into the Future of the Research

“…In particular, proper mediastinal staging is fundamental in preoperative evaluation. F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is routinely used as a preoperative non-invasive staging method of lymph node status for lung cancer [18]. The literature shows that the downstaging of LNM based on PET/CT findings was observed in almost 14% of patients, and upstaging was observed in 8%.…”