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Open Access 01-12-2021 | Computed Tomography | Research

Efficacy of positron emission tomography in diagnosis of lateral lymph node metastases in patients with rectal Cancer: a retrospective study

Authors: Ryohei Yukimoto, Mamoru Uemura, Takahiro Tsuboyama, Tsuyoshi Hata, Shiki Fujino, Takayuki Ogino, Norikatsu Miyoshi, Hidekazu Takahashi, Taishi Hata, Hirofumi Yamamoto, Tsunekazu Mizushima, Akira Kida, Mamoru Furuyashiki, Yuichiro Doki, Hidetoshi Eguchi

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

The presence of lateral pelvic lymph node (LLN) metastasis is an essential prognostic factor in rectal cancer patients. Thus, preoperative diagnosis of LLN metastasis is clinically important to determine the therapeutic strategy. The aim of this study was to evaluate the efficacy of preoperative positron emission tomography/computed tomography (PET/CT) in the diagnosis of LLN metastasis.

Methods

Eighty-four patients with rectal cancer who underwent LLN dissection at Osaka University were included in this study. The maximum standardized uptake value (SUV_max) of the primary tumor and LLN were preoperatively calculated using PET/CT. Simultaneously, the short axis of the lymph node was measured using multi-detector row computed tomography (MDCT). The presence of metastases was evaluated by postoperative pathological examination.

Results

Of the 84 patients, LLN metastases developed in the left, right, and both LLN regions in 6, 7, and 2 patients, respectively. The diagnosis of the metastases was predicted with a sensitivity of 82%, specificity of 93%, positive predictive value of 58%, negative predictive value of 98%, false positive value of 7%, and false negative value of 18% when the cutoff value of the LLN SUV_max was set at 1.5. The cutoff value of the short axis set at 7 mm on MDCT was most useful in diagnosing LLN metastases, but SUV_max was even more useful in terms of specificity.

Conclusions

The cutoff value of 1.5 for lymph node SUV_max in PET is a reasonable measure to predict the risk of preoperative LLN metastases in rectal cancer patients.

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Title: Efficacy of positron emission tomography in diagnosis of lateral lymph node metastases in patients with rectal Cancer: a retrospective study
Authors: Ryohei Yukimoto
Mamoru Uemura
Takahiro Tsuboyama
Tsuyoshi Hata
Shiki Fujino
Takayuki Ogino
Norikatsu Miyoshi
Hidekazu Takahashi
Taishi Hata
Hirofumi Yamamoto
Tsunekazu Mizushima
Akira Kida
Mamoru Furuyashiki
Yuichiro Doki
Hidetoshi Eguchi
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Rectal Cancer
Metastasis
Rectal Cancer
Computed Tomography
Positron Emission Tomography
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08278-6

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