Hyun Ju Lee MD, PhD, Presenter: Nothing to Disclose

Jin Mo Goo MD, PhD, Abstract Co-Author: Nothing to Disclose

Chang Hyun Lee MD, Abstract Co-Author: Nothing to Disclose

Jung-Gi Im MD, Abstract Co-Author: Nothing to Disclose

To examine the efficacy of integrated PET/CT using fluorodeoxyglucose for preoperative nodal staging in patients with non-small cell lung cancer (NSCLC) who were diagnosed as N0 stage on standalone CT.

From Oct/03 to Nov/04, in 42 patients (27 men and 15 women; mean age, 61 years) with NSCLC who were diagnosed as N0 stage on standalone CT, preoperative integrated PET/CT and curative surgical resection were performed. No patient had received preoperative chemotherapy. A total of 229 nodal groups in 42 patients that surgically resected were evaluated on integrated PET/CT. Histopathologic results served as the reference standard. The pathological nodal stages were evaluated and the number of patients in whom the nodal stage was changed by integrated PET/CT was counted. The sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of integrated PET/CT on a person basis and on a nodal group basis were calculated.

The pathological nodal stages were N0 in 31 patients, N1 in five patients, and N2 in six patients. In a patient with surgical N2 stage, the nodal stage was correctly changed by integrated PET/CT. On a person basis, the sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of integrated PET/CT were 9%, 94%, 71%, 94%, and 33%. On a nodal group basis, the sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of integrated PET/CT were 22%, 98%, 95%, 98%, and 33%. Seven false negative interpretations were rendered at PET/CT for evaluation of three subcarinal, two paratracheal, and two prevascular groups. Four false positive interpretations were rendered at integrated PET/CT for evaluation of one hilar, one interlobar, one subcarinal, and one paratracheal groups.

The diagnostic performance of for detecting metastatic lymphadenopathy did not significantly improved by integrated PET/CT in patients with NSCLC who were diagnosed as N0 stage on CT. The sensitivity of integrated PET/CT for detecting metastatic lymphadenopathy in patients with N0 stage on CT is not so high.

Lee, H, Goo, J, Lee, C, Im, J, The Efficacy of Integrated PET/CT Using Fluorodeoxyglucose for Preoperative Nodal Staging in Non-Small Cell Lung Cancer Diagnosed as N0 on CT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417440.html