Hiroshi Kodama, Presenter: Nothing to Disclose

Shuichi Murashima MD, Abstract Co-Author: Nothing to Disclose

Kan Takeda MD, Abstract Co-Author: Nothing to Disclose

In nodal staging of non-small cell lung cancer (NSCLC), 18F-FDG PET/CT by evaluating nodal FDG uptake is imperfect, especially when the size of metastatic foci is small. The aim of this retrospective study was to assess whether evaluation of the characteristics of primary tumor on 18FDG-PET/CT is helpful in nodal staging.

We reviewed 18F-FDG PET/CT findings of 98 NSCLC patients (62 adenocarcinoma, 26 squamous cell carcinoma and 10 others) who underwent surgical treatment with lymphadenectomy. The patients with bulky lymph node metastases were not included in this study. Lymph node metastases were revealed pathologically in 23 pts. SUVs of the primary tumors were calculated on PET images and compared between pts with and without nodal metastasis.

The mean maximum tumor diameter on CT image was 2.9±1.5cm and the mean SUV of primary tumor was 5.8±4.1 in all cases. There was no significant difference in size and histological type between patients with and without nodal metastasis. The mean SUV did not have significant difference between them (patients with nodal metastasis, 6.4±3.5 vs. pts without nodal metastasis, 5.6±4.2). However, the tumors with SUV smaller than 2.5 (n=24) revealed no lymph node metastasis invariably, regardless of tumor size (range, 0.9-3.5cm) or histological type.

The primary lung tumor with SUV smaller than 2.5 did not have nodal metastasis regardless of tumor size or histological type. Those patients may be candidates for less invasive treatment such as segmentectomy without lymphadenectomy, radiofrequency ablation or stereotactic radiotherapy as a curative therapy.

The primary lung tumor with SUV smaller than 2.5 did not have nodal metastasis regardless of tumor size or histological type.

Kodama, H, Murashima, S, Takeda, K, Assessment of Lymph Node Staging of Non-small Cell Lung Cancer by Evaluating Primary Tumor on 18F-FDG PET/CT.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6014473.html