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Is it possible to achieve more accurate mediastinal nodal radiotherapy planning for NSCLC with PET/CT?

To assess whether more accurate mediastinal lymph nodes radiotherapy can be performed with fluorode oxyglu cosepositron emission tomogaphy/computed tomography. The retrospective study was conducted at Inonu University Medical Faculty, Malatya, Turkey, and Afyon Kocatepe University Medical Faculty, A...

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Published in:Journal of the Pakistan Medical Association 2020-01, Vol.70 (1), p.29-34
Main Authors: Simsek, Fikri Selcuk, Koroglu, Reyhan, Elmali, Ferhan, Comak, Aylin, Ulutas, Hakki, Balci, Tansel Ansal, Asik, Muhammed, Akatli, Aysenur, Kekilli, Ersoy, Oner, Ali Ozan
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container_title Journal of the Pakistan Medical Association
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creator Simsek, Fikri Selcuk
Koroglu, Reyhan
Elmali, Ferhan
Comak, Aylin
Ulutas, Hakki
Balci, Tansel Ansal
Asik, Muhammed
Akatli, Aysenur
Kekilli, Ersoy
Oner, Ali Ozan
description To assess whether more accurate mediastinal lymph nodes radiotherapy can be performed with fluorode oxyglu cosepositron emission tomogaphy/computed tomography. The retrospective study was conducted at Inonu University Medical Faculty, Malatya, Turkey, and Afyon Kocatepe University Medical Faculty, Afyon, Turkey, and comprised record of patients histopathologically diagnosed with non-small cell lung carcinoma and who underwent fluorodeoxyglucose positron emission tomography / computed tomography between January 2013 and December 2016. Surgery and pathology reports of the patients were reviewed. Histopathologically proven malignant and benign lymph nodes were re-identified with fluorodeoxyglucose positron emission tomography / computed tomography imaging. Anatomical and metabolic parameters of lymph nodes were re-assessed by specialists and compared with histopathology reports. Maximum standardised uptake values were used to assess sensitivity, specificity, positive predictive value, and negative predictive values. SPSS 22 was used for data analysis. The study included 144 mediastinal lymph nodes related to 42 patients who had a mean age of 62.4±9.8 years (range: 41-79 years). In terms of subtypes of the primary squamous cell carcinoma was found in 24(57.2%) patients, adenocarcinoma in 12(27.5%), and other subtypes in 6(15.3%) patients. Of the 144 lymph nodes, 48(33.3%) were metastatic. Sensitivity, specificity, positive predictive value, and negative predictive value were 92.8%, 64.3%, 56.9%, and 94.7%, respectively when maximum standardised uptake value >2.5 was used as the malignancy criterion. When lymph node maximum standardised uptake value / liver standardised uptake value-mean>1.69 was used as the criterion, the sensitivity, specificity, positive predictive value, and negative predictive value were 95.83%, 91.67%, 85.2%, and 97.8%, respectively. When the same values with lymph node >8mm was used as the criterion, the four resultant values were 89.6%, 93.8%, 87.8%, and 94.7%, respectively. When lymph node was replaced with mean attenuation >35 as the criterion, the consequent values were 79.2%, 93.8%, 86.4%, and 90.0%, respectively. Lymph node maximum standardised uptake value / liver standardised uptake valuemean> 1.69 was associated with higher negative predictive value and more useful positive predictive value compared to maximum standardised uptake value >2.5. When this parameter was used along with short axis or mean attenuation value, there were
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subjects Cancer
Carcinoma
Diagnostic imaging
Health aspects
Lung cancer
Non-small cell lung cancer
Positron emission tomography
Radiation (Physics)
Radiotherapy
Surgery
title Is it possible to achieve more accurate mediastinal nodal radiotherapy planning for NSCLC with PET/CT?
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