دورية أكاديمية
Is FDG-PET/CT used correctly in the combined approach for nodal staging in NSCLC patients?
العنوان: | Is FDG-PET/CT used correctly in the combined approach for nodal staging in NSCLC patients? |
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المؤلفون: | Simsek FS; Department of Nuclear Medicine, Pamukkale University, Faculty of Medicine, Denizli, Turkey., Comak A; Department of Nuclear Medicine, Inonu University, Faculty of Medicine, Malatya, Turkey., Asik M; Department of Nuclear Medicine, Afyon Kocatepe University, Faculty of Medicine, Afyon, Turkey., Kuslu D; Department of Nuclear Medicine, Medical Sciences University, Antalya Education and Research Hospital, Antalya, Turkey., Balci TA; Department of Nuclear Medicine, Firat University, Faculty of Medicine, Elazig, Turkey., Ulutas H; Department of Thoracic Surgery, Inonu University, Faculty of Medicine, Malatya, Turkey., Koroglu R; Department of Nuclear Medicine, Afyon Kocatepe University, Faculty of Medicine, Afyon, Turkey., Kekilli E; Department of Nuclear Medicine, Inonu University, Faculty of Medicine, Malatya, Turkey., Akatli A; Department of Pathology, Inonu University, Faculty of Medicine, Malatya, Turkey., Elmali F; Department of Biostatistics, Izmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey., Yalcin NC; Department of Thoracic Surgery, Medical Sciences University, Antalya Education and Research Hospital, Antalya, Turkey., Akyol H; Department of Pathology, Medical Sciences University, Elazig State Hospital, Elazig, Turkey. |
المصدر: | Nigerian journal of clinical practice [Niger J Clin Pract] 2020 Jun; Vol. 23 (6), pp. 842-847. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Medknow Publications Country of Publication: India NLM ID: 101150032 Publication Model: Print Cited Medium: Internet ISSN: 1119-3077 (Print) NLM ISO Abbreviation: Niger J Clin Pract Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Mumbai : Medknow Publications Original Publication: [Lagos?] : Medical and Dental Consultants' Association of Nigeria |
مواضيع طبية MeSH: | Carcinoma, Non-Small-Cell Lung/*diagnostic imaging , Fluorodeoxyglucose F18/*metabolism , Lung Neoplasms/*diagnostic imaging , Neoplasm Staging/*methods , Positron Emission Tomography Computed Tomography/*methods , Tomography, X-Ray Computed/*methods, Adult ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Non-Small-Cell Lung/metabolism ; Carcinoma, Non-Small-Cell Lung/pathology ; Endosonography/methods ; Female ; Humans ; Lung Neoplasms/metabolism ; Lung Neoplasms/pathology ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology ; Lymphatic Metastasis/pathology ; Male ; Mediastinum/pathology ; Middle Aged ; Multimodal Imaging ; Radiopharmaceuticals/administration & dosage ; Radiopharmaceuticals/metabolism ; Retrospective Studies ; Sensitivity and Specificity |
مستخلص: | Background: The most widely accepted approach nowadays in nodal staging of non-small cell lung cancer (NSCLC) is the combined use of 18-Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). However, this approach may not be sufficient, especially for early stages. Aims: Our aim was to assess whether more satisfactory results can be obtained with standardized uptake value maximum lymph node/standardized uptake value mean mediastinal blood pool (SUVmax LN/SUVmean MBP), SUVmax LN/Primary tumor, or a novel cut-off value to SUVmax in this special group. Subjects and Methods: Patients with diagnosed NSCLC and underwent FDG-PET/CT were reviewed retrospectively. 168 LNs of 52 early stage NSCLC patients were evaluated. The LNs identified in surgery/pathology reports were found in the FDG-PET/CT images. Anatomic and metabolic parameters were measured. Statistical analysis was performed by using of MedCalc Statistical Software. Results: Regardless of LNs size; sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SUVmax >2.5 were 91.5%, 65.9%, 58.2%, and 95.1%, respectively. Optimum cut-off value of SUVmax was >4.0. Sensitivity, specificity, PPV, and NPV were found as 81.0%, 90.0%, 81.0%, and 90.0% respectively. Optimum cut-off value of SUVmax LN/SUVmean MBP was >1.71. Sensitivity, specificity, PPV, and NPV were found as 94.7%, 80.0%, 71.1%, and 96.7%, respectively. Optimum cut-off value of SUVmax LN/Primary tumor was >0.28. Sensitivity, specificity, PPV, and NPV were found as 81.1%, 85.1%, 72.9% and 90.1%, respectively. Conclusion: SUVmax LN/SUVmean MBP >1.71 has higher PPV than currently used, with similar NPV and sensitivity. This can provide increase in the accuracy of combined approach. In this way, faster nodal staging/treatment decisions, cost savings for healthcare system and time saving of medical professionals can be obtained. Competing Interests: None |
فهرسة مساهمة: | Keywords: EBUS-TBNA; FDG-PET/CT; NSCLC; staging |
المشرفين على المادة: | 0 (Radiopharmaceuticals) 0Z5B2CJX4D (Fluorodeoxyglucose F18) |
تواريخ الأحداث: | Date Created: 20200612 Date Completed: 20200805 Latest Revision: 20220415 |
رمز التحديث: | 20221213 |
DOI: | 10.4103/njcp.njcp_2_19 |
PMID: | 32525121 |
قاعدة البيانات: | MEDLINE |
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