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

• Published in: European journal of radiology 2010-08, Vol.75 (2), p.143-146
• Main Authors: Kasai, Takami, Motoori, Ken, Horikoshi, Takuro, Uchiyama, Katsuhiro, Yasufuku, Kazuhiro, Takiguchi, Yuichi, Takahashi, Fumiaki, Kuniyasu, Yoshio, Ito, Hisao
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - surgery; Contrast Media; Dual-time point scanning; Female; Fluorodeoxyglucose F18; Humans; Integrated FDG PET/CT; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymph node metastasis; Lymph Nodes - pathology; Male; Mediastinum; Middle Aged; Moon; Non-small cell lung cancer; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals; ROC Curve; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Young Adult
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2009.04.044

Abstract Purpose To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Materials and methods PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1 h, and on delayed scans (SUVd) 2 h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p < 0.05 was considered statistically significant. Results Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation. Conclusion Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.