The role of the PET-CT in staging of lung cancer.
- Author:
Sung Ho KI
1
;
Seung Hee LEE
;
In Young HYUN
;
Kyung Hee LEE
;
Jae Hwa CHO
;
Jeong Seon RYU
;
Hong Lyeol LEE
;
Seung Min KWAK
Author Information
1. Department of Internal Medicine, Collage of Medicine Inha University, Incheon, Korea. smkwak@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Lung Cancer;
Cancer Staging;
Computed Tomography;
PET-CT
- MeSH:
Carcinoma, Non-Small-Cell Lung;
Diagnosis;
Humans;
Lung Neoplasms*;
Lung*;
Lymph Nodes;
Lymphatic Diseases;
Mediastinoscopy;
Neoplasm Metastasis;
Neoplasm Staging;
Sensitivity and Specificity;
Unnecessary Procedures
- From:Korean Journal of Medicine
2006;71(6):627-634
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: PET-CT can provide both a physiological and anatomical image with the benefits of both PET and CT scanners. This may improve the accuracy of a diagnosis of a mediastinal lymph node metastasis. The aims of this study were to compare PET-CT versus CT on the nodal staging of lung cancer and to determine if it could be used to avoid an invasive diagnostic examination. The benefit of the additional PET-CT as preoperative evaluation of the lung cancer was also assessed. METHODS: The results of CT and PET-CT scanning in 22 patients with a proven non-small cell lung cancer (NSCLC) were correlated with the pathological findings of lymph node sampling using mediastinoscopy or surgery. RESULTS: The sensitivity, specificity, accuracy, positive and negative predictive values of CT for detecting metastatic lymphadenopathy were 44%, 77%, 64%, 57%, and 67%, respectively. For PET-CT, these were 78%, 92%, 86%, 88%, and 86%, respectively. The earlier detection of a bone metastasis was obtained by PET-CT in 3 cases, which was not detected in bone scan. CONCLUSIONS: Better results for nodal staging and higher negative-predictive values by PET-CT (than CT) can avoid the need for invasive mediastinal staging of the lung cancer with negative mediastinal lymph node metastasis. An additional histological evaluation by mediastinoscopy needs to be done when positive findings are detected by PET-CT. PET-CT is also helpful in detecting a distant metastasis and avoiding unnecessary surgery. More accurate diagnostic staging can be expected using the simultaneous execution of PET-CT with a conventional preoperative evaluation of lung cancer.
