PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma

Kernstine, Kemp H.; Stanford, William; Mullan, Brian F.; Rossi, Nicholas P.; Thompson, Brad; Bushnell, David; McLaughlin, Kelley; Kern, Jeffrey A.

doi:10.1016/s0003-4975(99)00788-2

Cited by 110 publications

(47 citation statements)

References 30 publications

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“…The considerable range of CVs for inflammatory LNs (0.07-0.32) in this study might be due F-FDG uptake. Several studies have used an SUV threshold of 2.5 for differentiating benign and metastatic mediastinal LN in lung cancer [13][14][15]. Hellwig et al [13] preferred to use 2.5 as cutoff value, instead of 4.5 as their best accuracy, in order to reduce the FN results.…”

Section: Discussionmentioning

confidence: 99%

“…Uptake of the 18 F-FDG-avid LNs was also visually scored using three grades of intensity of mediastinal blood pool (0=similar with mediastinal blood pool, 1=faintly positive, 2=definitely positive). SUV threshold of 2.5 was used for differentiating between metastatic and benign LNs in lung cancer [13][14][15]. Highly attenuated nodes were defined as those that had HU max >120 [16] as one of the diagnostic criteria in determining benign LN in patients with non-smallcell lung cancer.…”

Section: Image Analysismentioning

confidence: 99%

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Heterogeneity Analysis of 18F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting

Budiawan

Cheon

et al. 2013

Nucl Med Mol Imaging

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Purpose Lymph node (LN) characterization is crucial in determining the stage and treatment decisions in patient with lung cancer. Although Results Metastatic lymph nodes tended to have higher CVs than the inflammatory LNs. The mean CV of metastatic LNs (0.30±0.08; range: 0.08-0.55) was higher than that of inflammatory LNs (0.17+0.06; range, 0.07-0.32; P<0.0001). On receiver operating characteristic (ROC) curve analysis, the area under curve was 0.901, and using 0.20 as cut-off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 88.5 %, 76.2 %, 82.2 %, 84.3, and 83.0 % respectively. Accuracy of CV was slightly higher than SUVmax and diameter, but significantly higher than visual assessment and HUmax. Conclusions In patients with adenocarcinoma of the lung having no prior treatments, metastatic LNs showed more heterogeneous 18 F-FDG uptake than inflammatory LNs. Measuring the CV of the SUV derived from a manual volume of interest (VOI) can be helpful in determining metastatic LN of adenocarcinoma of the lung. Including diagnostic criteria of CV into the diagnostic approach can increase the accuracy of mediastinal node status.

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Section: Discussionmentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

Heterogeneity Analysis of 18F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting

Budiawan

Cheon

et al. 2013

Nucl Med Mol Imaging

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“…Kernstine et al [20] reported the sensitivity of PET, CT and MRI as 70%, 65% and 86%, respectively along with a specificity of 86%, 79% and 82%. No significant difference was found between the three methods.…”

Section: Discussionmentioning

confidence: 99%

The role of tumor SUVmax/lymph node SUVmax ratio viewed on PET-CT in the detection of mediastinal metastasis in patients with lung cancer

Oztas¹

2012

Turk Gogus Kalp Dama

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Amaç: Bu çalışmada, küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında mediastinal lenf nodu evrelemesinde pozitron emisyon tomografi-bilgisayarlı tomografinin (PET-BT) duyarlığını saptamada lenf nodu standardize alım değeri (SUDmax)/kitle SUDmax oranı araştırıldı.Ça lış m a pla nı: Çalışmamıza Ocak 2007 -Ekim 2010 tarihleri arasında Süreyyapaşa Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi 9. Göğüs Hastalıkları kliniğinde patolojik olarak kanıtlanmış 31 KHDAK hastası (3 kadın, 28 erkek; ort. yaş 61.0±9.2 yıl; dağılım 35-79 yıl) alındı. Bu hastalar evreleme amacıyla PET-BT çekilmiş ve mediastinoskopi yapılmış hastalar idi. Mediastinoskopi ile patolojik tanısı gösterilen lenfadenomegalilerin (lenf nodu) PET-BT SUDmax değerleri primer kitlenin SUDmax değeri ile karşılaştırılarak, kitle SUDmax/lenf nodu SUDmax oranları saptandı. Bu oranlar 1.5 ve 2.5 kesme değerleri ile üç gruba ayrılarak, metastazı saptamadaki doğrulukları incelendi. Bul gu lar:Lenfadenomegali patolojisi sonucu pozitif olan olgular ile negatif olan olguların kitle SUDmax düzeyleri arasında istatistiksel olarak anlamlı bir farklılık bulunmadı (p>0.05). Lenfadenomegali patolojisi sonucu pozitif olan olguların lenf nodu SUDmax düzeyleri, patoloji sonucu negatif olan olgulardan istatistiksel olarak ileri düzeyde anlamlı yüksek idi (p<0.01). Lenfadenomegali patolojisi pozitifliği ile kitle SUDmax/lenf nodu SUDmax arasında istatistiksel olarak ileri düzeyde anlamlı bir ilişki bulunmakta idi (p<0.01). Lenfadenomegali patolojisi pozitif olgularda kitle SUDmax/lenf nodu SUDmax oranının 0 ile 1.5 arasında olma oranı yüksek iken, patolojisi negatif olgularda kitle SUDmax/lenf nodu SUDmax oranının 2.5 ve üzerinde olma oranı yüksek idi. So nuç:Araştırmamızın sonucunda KHDAK'li olgularda PET-BT'de kitle SUDmax/lenf nodu SUDmax oranının mediastinal metastaz varlığı ile ilişkili olduğu görüldü. Ayrıca SUDmax oranında 2.5'lik kesme değerinin üstüne çıktığında ileri derecede anlamlı olarak PET-BT'deki yalancı pozitifliğin arttığı sonucuna varıldı.Anah tar söz cük ler: Metastaz tanısı; mediastinal lenf nodu standardize alım değe-ri; küçük hücreli dışı akciğer kanseri; pozitron emisyon tomografisi-bilgisayarlı tomografi. Background:In this study, we aimed to investigate the lymph node standardized uptake value (SUVmax)/mass SUVmax ratio for the determination of sensitivity of positron emission tomography-computed tomography (PET-CT) in mediastinal lymph node staging in patients with non-small cell lung cancer (NSCLC).

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“…The role of FDG-PET in non-small cell lung cancer (NSCLC) has been widely studied, with a trend to upstaging compared to conventional CT scans along with [10][11][12][13][14][15][16][17][18][19] a change in clinical management [20][21][22][23][24][25] . In fact, the intensity of FDG uptake in NSCLC, as measured by highest standard uptake value [SUV max ] has also been shown to correlate with prognosis [26] .…”

Section: -[18f]-fluoro-2-deoxy-d-glucose (Fdg) Positron Emission Tommentioning

confidence: 99%

Prognostic value of FDG-PET scans at diagnosis in small cell lung cancer

Said

Koshy

Rizk

et al. 2013

JBGC

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Background: Small cell lung carcinoma (SCLC) is one of the most aggressive solid tumors. The predictive and prognostic role of positron emission tomography (PET) scans in SCLC is under investigation and is yet to be determined. Method:We retrospectively analyzed the correlation between overall survival and 2-[18F]-fluoro-2-deoxy-d-glucose-PET (FDG-PET) results at diagnosis. We also introduced the concept of the total standardized uptake value (SUV) as a possible biomarker for the total burden disease. In addition, we proposed a new staging concept using PET scan based on whether tumor uptake is or is not limited to parenchymal hemithorax. Results:Between March 2004 and February 2009, 46 patients with histologically confirmed SCLC were included in the analysis. Thirty patients were found to have Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2, and most (65%, n = 30) of them had limited stage disease using conventional clinical staging criteria. There was a fair correlation between PET results and conventional staging by CT scan (kappa = 0.330). Although there was a trend toward upstaging by PET, it was not predictive of survival. There was a direct correlation between total SUV and maximum SUV and overall survival (hazard ratio [HR] = 1.003 and 1.085, respectively). Conclusion:PET scan results at diagnosis could play an important role in the management of SCLC. Total SUV could represent a good biomarker for the disease burden in SCLC. Further prospective studies are needed to clarify the application of total SUV in SCLC.

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PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma

Cited by 110 publications

References 30 publications

Heterogeneity Analysis of 18F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting

Heterogeneity Analysis of 18F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting

The role of tumor SUVmax/lymph node SUVmax ratio viewed on PET-CT in the detection of mediastinal metastasis in patients with lung cancer

Prognostic value of FDG-PET scans at diagnosis in small cell lung cancer

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