Nonpalpable Supraclavicular Lymph Nodes in Lung Cancer Patients: Preoperative Characterization with ¹⁸F-FDG PET/CT

Abstract

Because of its high sensitivity and negative predictive value, integrated PET/CT is useful in the detection and characterization of nonpalpable supraclavicular lymph nodes in lung cancer patients.

Percutaneous Ultrasound-Guided Biopsies in the Evaluation of Thoracic Tumours after PET-CT: A Prospective Diagnostic Study

“…In this study, we focused on PET-CT-positive supraclavicular findings and demonstrated malignancy in the majority of patients suspected to have a thoracic neoplasm, especially NSCLC. PET-CT has a diagnostic accuracy of 71% in detecting non-palpable supraclavicular lymph node metastasis as was demonstrated in a group of 32 patients with NSCLC [15]. In our study, accuracy was 85%.…”

PET and Neck Ultrasound for the Detection of Cervical Lymphadenopathy in Patients with Lung Cancer and Mediastinal Lymphadenopathy

“…The diagnostic accuracy of PET for malignant neck lymphadenopathy in lung cancer has previously been studied; Sung et al [7] reported on 32 patients with cervical lymphadenopathy detected on PET and/or CT and found a false-positive rate of 19%. The authors reported an SUV max of 2.3 to be the optimum cut-off for differentiating true-and false-positive findings.…”

“…One study demonstrated that PET-CT was associated with false-positive findings in the neck in 19% of cases [7]. More studies were performed on the role of PET-CT for the detection of neck lymphadenopathy in head and neck cancer, and within this patient population, PET-CT had a positive predictive value (PPV) of 60-87% and a specificity of 65-70% [8,9].…”

The usefulness of combined axial and coronal computed tomography for the evaluation of metastatic supraclavicular lymph nodes

“…In previous reports, CT appeared to be ineffective compared with other imaging modalities such as 18 F-FDG PET/CT and ultrasonography [2,4,[6][7][8][9]15]. Sung et al suggested several causes of false-negative and false-positive interpretations on CT [8].…”

“…Especially for supraclavicular LNs, there are substantial numbers of false-positive and false-negative results with CECT than with other imaging modalities such as ultrasonography and 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) [4][5][6][7][8][9]. Despite its less accurate reflection of presence of pathologic LNs than other modalities, CT imaging is the most common imaging modality as it is relatively inexpensive and accessible within most communities [10].…”