Original Article

European Journal of Nuclear Medicine

, Volume 23, Issue 7, pp 741-747

The usefulness of FDG positron emission tomography for the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer: a comparative study with X-ray computed tomography

  • Masayuki SasakiAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Yuichi IchiyaAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Yasuo KuwabaraAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Yuko AkashiAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Tsuyoshi YoshidaAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Toshimitsu FukumuraAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Sadayuki MurayamaAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University
  • , Teruyoshi IshidaAffiliated withDepartment of Surgery II, Faculty of Medicine, Kyushu University
  • , Kenji SugioAffiliated withDepartment of Surgery II, Faculty of Medicine, Kyushu University
    • , Kouji MasudaAffiliated withDepartment of Radiology, Faculty of Medicine, Kyushu University

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Abstract

We evaluated the usefulness of fluorine-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) in the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer and then compared the findings with the results of X-ray CT by region based on the histological diagnoses. We examined 29 patients with non-small cell lung cancer. One hundred and thirty-two mediastinal lymph nodes were surgically removed and the histological diagnoses were confirmed. FDG PET images, including 146 mediastinal regions, were visually analysed and the mediastinal lymph nodes were scored as positive when the FDG uptake was higher than that in the other mediastinal structures. On the X-ray CT scans, any mediastinal lymph nodes with a diameter of 10 mm or larger were scored as positive. All three examinations were successfully performed on 71 regions. For FDG PET, we found a sensitivity of 76%, a specificity of 98% and an accuracy of 93%. On the other hand, for X-ray CT a sensitivity of 65%, a specificity of 87% and an accuracy of 82% were observed. A significant difference was observed in respect of both specificity and accuracy (P<0.05). Based on the above findings, FDG PET is suggested to be superior to X-ray CT when used for the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer.

Key words

Lung cancer Mediastinal lymph node Fluorine-18-fluoro-2-deoxy-d-glucose Positron emission tomography