The accuracy of integrated PET-CT compared with dedicated pet alone for the staging of patients with nonsmall cell lung cancer

Cerfolio, Robert J.; Ojha, Buddhiwardhani; Bryant, Ayesha S.; Raghuveer, Vanguru; Mountz, James M.; Bartolucci, Alfred A.

doi:10.1016/j.athoracsur.2004.02.067

Cited by 324 publications

(218 citation statements)

References 19 publications

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“…The diagnostic performance of PET could be different for N1, N2, and N3 lymph node stations [5,35]. For example, the accuracy of PET/CT for lymph node metastasis was 93% for N1, 77% for N2, and 60% for N3 [35]. According to our preliminary data, the cutoff value for a visual score in N1 lymph nodes of the ILD group was 0 and below, which could not be applied to clinical PET/CT interpretation.…”

Section: Discussionmentioning

confidence: 79%

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Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Sun

Park

et al. 2008

Lung

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As 18 F-fluorodeoxyglucose (FDG) is taken up by inflammatory lymph nodes, it could be falsely interpreted as metastasis. Therefore, we evaluated the diagnostic ability of positron emission tomography/computed tomography (PET/CT) for lymph node staging of lung cancer when inflammatory lung disease coexisted. Patients with operable non-small-cell lung cancer and FDG-avid lymph nodes were retrospectively classified into two groups; those with inflammatory lung disease (ILD) and those without it (NILD). Receiver operating characteristic (ROC) curve analysis was performed for maximum standardized uptake value (SUVmax), pattern of FDG uptake, maximum Hounsfield unit, and size, and then the areas under the ROC curves (AUCs) were compared between subgroups. There were 124 patients (ILD/ NILD = 38/86) and 396 FDG-avid lymph nodes (ILD/ NILD = 140/256). The average number of FDG-avid lymph nodes was greater in ILD (3.7 vs. 2.9, p = 0.039), whereas the proportion of metastasis was higher in NILD (25.4% vs. 11.4%, p = 0.002). With all N1-N3 lymph nodes and the NILD group, the AUC values of all four parameters were significantly greater than 0.5 (p \ 0.05), and SUVmax was the most valuable parameter for lymph node metastasis. However, in the ILD group, only the AUC value of SUVmax was significantly greater than 0.5. These results were reproduced when analyses were performed with N1-N2 lymph nodes. In conclusion, SUVmax was the most valuable PET/CT parameter for assessment of lymph node metastasis in patients with operable non-small-cell lung cancer. In addition, it was the only valuable parameter when inflammatory lung disease coexisted.

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Section: Discussionmentioning

confidence: 79%

“…Instead, we analyzed all resectable N1 and N2 lymph nodes in total. The diagnostic performance of PET could be different for N1, N2, and N3 lymph node stations [5,35]. For example, the accuracy of PET/CT for lymph node metastasis was 93% for N1, 77% for N2, and 60% for N3 [35].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Sun

Park

et al. 2008

Lung

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“…To achieve this goal, computed tomography (CT), bone scintigraphy, and whole-body positron emission tomography with [18F]fluoro-2-Dglucose (FDG-PET) are commonly utilized. Moreover, technological advances have promoted FDG-PET image fused with CT (PET/CT) as the new modality for various oncology imaging procedures (3)(4)(5)(6).…”

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confidence: 99%

Diagnostic value of whole‐body magnetic resonance imaging for bone metastases: a systematic review and meta‐analysis

Zheng

et al. 2011

Magnetic Resonance Imaging

117

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Purpose: To assess the overall diagnostic accuracy of whole-body magnetic resonance imaging (WB-MRI) in detecting bone metastases with a meta-analysis. Materials and Methods:The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched from January 1995 to September 2010 for studies evaluating the accuracy of WB-MRI in detecting bone metastases. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months was assessed. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristics.Results: A total of 11 studies with 495 patients who fulfilled all of the inclusion criteria were considered for the analysis. No publication bias was found. WB-MRI had a pooled sensitivity of 0.899 (95% confidence interval [CI], 0.845-0.939) and a pooled specificity of 0.918 (95% CI, 0.882-0.946). The subgroup without diffusion-weighted imaging (DWI) positive results had higher pooled specificity 0.961 (95% CI, 0.922-0.984) than the subgroup with DWI (P < 0.05).Conclusion: WB-MRI was an accurate, cost-effective tool in detecting bone metastases. WB-MRI without DWI may improve the specificity of detecting bone metastases. DWI seems to be a sensitive but rather unspecific modality for the detection of bone metastatic disease. High-quality prospective studies regarding WB-MRI in detecting bone metastases still need to be conducted.

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“…In Japan, mediastinoscopy for patients with mediastinal nodes measuring 1 cm or less in size on CT is not performed as a routine clinical practise, and nor was it in our study. Although the introduction of PET may improve the accuracy of the clinical staging, it would still be unlikely to be comparable to surgical staging (Lardinois et al, 2003;Cerfolio et al, 2004;Shim et al, 2005). This would inevitably lead to heterogeneity of the patient population, necessitating a sophisticated study design and large sample size for any future trial on preoperative therapy.…”

Section: Discussionmentioning

confidence: 99%

A randomised phase II trial of preoperative chemotherapy of cisplatin–docetaxel or docetaxel alone for clinical stage IB/II non-small-cell lung cancer: results of a Japan Clinical Oncology Group trial (JCOG 0204)

et al. 2008

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Preoperative chemotherapy is a promising strategy in patients with early-stage resectable non-small-cell lung cancer (NSCLC); optimal chemotherapy remains unclear. Clinical (c-) stage IB/II NSCLC patients were randomised to receive either two cycles of docetaxel (D) -cisplatin (P) combination chemotherapy (D 60 mg m À2 and P 80 mg m À2 on day 1) every 3 -4 weeks or three cycles of D monotherapy (70 mg m À2 ) every 3weeks. Thoracotomy was performed 4 -5 weeks (DP) or 3 -4 weeks (D) after chemotherapy. The primary end point was 1-year disease-free survival (DFS). From October 2002 to November 2003, 80 patients were randomised. Chemotherapy toxicities were mainly haematologic and well tolerated. There were two early postoperative deaths with DP (one intraoperative bleeding and one empyema). Pathologic complete response was observed in two DP patients. Docetaxel -cisplatin was superior to D in terms of response rate (45 vs 15%) and complete resection rate (95 vs 87%). Both DFS and overall survival were better in DP. Disease-free survival at 1, 2 and 4 years were 78, 65 and 57% with DP, and were 62, 44 and 36% with D, respectively. Preoperative DP was associated with encouraging resection rate and DFS data, and phase III trials for c-stage IB/II NSCLC are warranted.

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The accuracy of integrated PET-CT compared with dedicated pet alone for the staging of patients with nonsmall cell lung cancer

Cited by 324 publications

References 19 publications

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Diagnostic value of whole‐body magnetic resonance imaging for bone metastases: a systematic review and meta‐analysis

A randomised phase II trial of preoperative chemotherapy of cisplatin–docetaxel or docetaxel alone for clinical stage IB/II non-small-cell lung cancer: results of a Japan Clinical Oncology Group trial (JCOG 0204)

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