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Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 3/2012

01-09-2012 | Original Article

Dual-time-point FDG PET/CT: Is It Useful for Lymph Node Staging in Patients with Non-Small-Cell Lung Cancer?

Authors: Dae-Weung Kim, Woo Hyoung Kim, Chang Guhn Kim

Published in: Nuclear Medicine and Molecular Imaging | Issue 3/2012

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Abstract

Purpose

Dual-time-point (DTP) FDG PET/CT has been shown to be useful for lymph node (LN) staging in patients with non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the LN staging ability of DTP FDG PET/CT in the predominant area of pulmonary tuberculosis.

Methods

Sixty-nine NSCLC patients underwent DTP PET/CT. Regions of interest were placed on each LN of each station, and the maximum SUVs were measured. Three variables were obtained: (1) the SUV on the early scan (SUVearly), (2) the SUV on the delayed scan (SUVdelayed), and (3) the retention index of the SUV (RI). Each patient had one final LN stage and three other LN stages according to the cutoff values of SUVearly, SUVdelayed, and RI.

Results

In the LN-based analysis, the area under the ROC curve of SUVdelayed (0.884) was significantly larger (P < 0.01) than those of SUVearly (0.868) and RI (0.717). Among the three variables, SUVdelayed was more accurate (P < 0.01) for detecting the mediastinal LN metastasis than SUVearly and RI. In the patient-based analysis, SUVdelayed had correctly determined LN stages in 55 of 69 patients (sensitivity, specificity, and accuracy = 88.7 %, 50.0 %, and 79.7 %), whereas SUVearly and RI correctly determined LN stages in 53 and 52 patients, respectively.

Conclusions

In this study, comparing the diagnostic efficacy of SUVearly, SUVdelayed, and RI for LN staging in patients with NSCLC, SUVdelayed was the most accurate variable for LN staging. DTP PET/CT could provide improved diagnostic accuracy for the LN staging of NSCLC.
Literature
1.
Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest. 1997;111:1710–7.PubMedCrossRef
2.
Gupta NC, Tamim WJ, Graeber GG, Bishop HA, Hobbs GR. Mediastinal lymph node sampling following positron emission tomography with fluorodeoxyglucose imaging in lung cancer staging. Chest. 2001;120:521–7.PubMedCrossRef
3.
Konishi J, Yamazaki K, Tsukamoto E, Tamaki N, Onodera Y, Otake T, et al. Mediastinal lymph node staging by FDG-PET in patients with non-small cell lung cancer: analysis of false-positive FDG-PET findings. Respiration. 2003;70:500–6.PubMedCrossRef
4.
Takamochi K, Yoshida J, Murakami K, Niho S, Ishii G, Nishimura M, et al. Pitfalls in lymph node staging with positron emission tomography in non-small cell lung cancer patients. Lung Cancer. 2005;47:235–42.PubMedCrossRef
5.
Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N. Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med. 1994;35:104–12.PubMed
6.
Nishiyama Y, Yamamoto Y, Kimura N, Ishikawa S, Sasakawa Y, Ohkawa M. Dual-time-point FDG-PET for evaluation of lymph node metastasis in patients with non-small-cell lung cancer. Ann Nucl Med. 2008;22:245–50.PubMedCrossRef
7.
Shinya T, Rai K, Okumura Y, Fujiwara K, Matsuo K, Yonei T, et al. Dual-time-point F-18 FDG PET/CT for evaluation of intrathoracic lymph nodes in patients with non-small cell lung cancer. Clin Nucl Med. 2009;34:216–21.PubMedCrossRef
8.
Uesaka D, Demura Y, Ishizaki T, Ameshima S, Miyamori I, Sasaki M, et al. Evaluation of dual-time-point 18F-FDG PET for staging in patients with lung cancer. J Nucl Med. 2008;49:1606–12.PubMedCrossRef
9.
Kasai T, Motoori K, Horikoshi T, Uchiyama K, Yasufuku K, Takiguchi Y, et al. Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Eur J Radiol. 2010;75:143–6.PubMedCrossRef
10.
Suga K, Kawakami Y, Hiyama A, Sugi K, Okabe K, Matsumoto T, et al. Differential diagnosis between (18)F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan. Ann Nucl Med. 2009;23:523–31.PubMedCrossRef
11.
Yen RF, Chen KC, Lee JM, Chang YC, Wang J, Cheng MF, et al. 18F-FDG PET for the lymph node staging of non-small cell lung cancer in a tuberculosis-endemic country: is dual time point imaging worth the effort? Eur J Nucl Med Mol Imaging. 2008;35:1305–15.PubMedCrossRef
12.
Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4:568–77.PubMedCrossRef
13.
Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med. 1994;35:1308–12.PubMed
14.
Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med. 2002;43:871–5.PubMed
15.
Gould MK, Kuschner WG, Rydzak CE, Maclean CC, Demas AN, Shigemitsu H, et al. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med. 2003;139:879–92.PubMed
16.
Kim DW, Kim CG. Dual-time point positron emission tomography findings of benign mediastinal lymph nodes in a tuberculosis-endemic region. Jpn J Radiol. 2011;29:682–7.PubMedCrossRef
Metadata
Title
Dual-time-point FDG PET/CT: Is It Useful for Lymph Node Staging in Patients with Non-Small-Cell Lung Cancer?
Authors
Dae-Weung Kim
Woo Hyoung Kim
Chang Guhn Kim
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Nuclear Medicine and Molecular Imaging / Issue 3/2012
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-012-0141-0

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