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Improved Specificity of $^{18}F-FDG$ PET/CT for Lymph Node Staging of Non-Small Cell Lung Cancer Considering Calcified Lymph Node as Benign  

Kwon, Seong-Young (Departments of Nuclear Medicine, Chonnam National University Hospital)
Seo, Young-Soon (Departments of Nuclear Medicine, Chonnam National University Hospital)
Min, Jung-Joon (Departments of Nuclear Medicine, Chonnam National University Hospital)
Song, Ho-Chun (Departments of Nuclear Medicine, Chonnam National University Hospital)
Na, Kook-Joo (Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital)
Choi, Chan (Department of Pathology, Chonnam National University Hospital)
Kim, Young-Chul (Department of Medicine, Chonnam National University Hospital)
Kim, Yun-Hyun (Department of Radiology, Chonnam National University Hospital)
Bom, Hee-Seung (Departments of Nuclear Medicine, Chonnam National University Hospital)
Publication Information
Nuclear Medicine and Molecular Imaging / v.41, no.1, 2007 , pp. 16-21 More about this Journal
Abstract
Purpose: We evaluated the diagnostic value of $^{18}F-FDG$ PET/CT (PET/CT) in lymph node staging of non-small cell lung cancer (NSCLC) considering calcification and histologic types as well as FDG uptake. Materials and Methods: Fifty-three patients (38 men, 15 women; mean age, 62 years) with NSCLC underwent surgical resection (tumor resection and lymph node dissection) after PET/CT. After surgery, we compared PET/CT results with the biopsy results, and analyzed lymph node metastases, based on histologic types. PET diagnosis of lymph node metastasis was determined by maximum SUV (maxSUV) > 3.0, and PET/CT diagnosis was determined by maxSUV > 3.0 without lymph node calcification. Results: By PET diagnosis, the sensitivity, specificity, and accuracy of overall lymph node staging were 45% (13 of 29), 91% (228 of 252), and 86% (241 of 281). Specificity was 91% in both squamous cell carcinoma and adenocarcinoma, while sensitivity was 71% in squamous cell carcinoma and 36% in adenocarcinoma. When we excluded calcified lymph node with maxSUV > 3.0 from metastasis by PET/CT diagnosis, specificity improved to 98% in squamous cell carcinoma and 97% in adenocarcinoma. The degree of improvement was not dependent on histologic types. Conclusion: PET/CT improved specificity of lymph node staging by reducing false positive lymph node regardless of histologic types of NSCLC.
Keywords
non-small cell lung cancer; lymph node staging; calcification; histoogy; $^{18}F-FDG$ PET/CT;
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