European Radiology

, Volume 22, Issue 7, pp 1556–1563 | Cite as

Accuracy and predictive features of FDG-PET/CT and CT for diagnosis of lymph node metastasis of T1 non-small-cell lung cancer manifesting as a subsolid nodule

  • Sang Min Lee
  • Chang Min Park
  • Jin Chul Paeng
  • Hyung Jun Im
  • Jin Mo Goo
  • Hyun-Ju Lee
  • Chang Hyun Kang
  • Young Whan Kim
  • Jung Im Kim
Chest

Abstract

Objectives

To retrospectively evaluate the diagnostic accuracy and predictive features of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG-PET/CT) and CT in lymph node (LN) staging of T1 non-small-cell lung cancers (NSCLCs) manifesting as subsolid nodules.

Methods

From January 2005 to May 2011, 160 patients with pathologically proven T1 subsolid NSCLCs with LN staging were included in this study. Diagnostic accuracies of FDG-PET/CT and CT for LN staging were evaluated. Maximum standardised uptake value (SUVmax) and CT features of primary tumours were evaluated to investigate predictive factors for LN metastasis.

Results

LN metastases were found in nine of the 160 patients (5.6%). No LN metastasis was present in patients with a solid proportion ≤50%. Sensitivity, specificity and accuracy of FDG-PET/CT for LN staging on a per-patient basis were 11.1%, 86.1% and 81.9%; those of CT were 11.1%, 96.7% and 91.9%. Among patients with a solid proportion >50%, there were significant differences in SUVmax, solid portion size, solid proportion and lesion location between patients with and without LN metastasis. Multivariate analysis revealed that higher SUVmax, a larger solid proportion and central location were independent predictors of LN metastasis.

Conclusions

FDG-PET/CT adds little value to CT in the lymph node staging of T1 subsolid NSCLCs.

Key Points

Lymph node (LN) metastases are important in non-small-cell lung cancer (NSCLC).

Positron emission tomography (PET) helps to stage solid NSCLCs.

FDG-PET/CT adds little to the LN staging of T1 subsolid NSCLCs.

No LN metastasis in patients with a solid proportion ≤50%.

LN metastasis is more common in solid and/or centrally sited tumours.

Keywords

NSCLC PET/CT CT Lymph node Staging 

Notes

Acknowledgements

This study was supported by the Research Grant of the Korean Foundation for Cancer Research (grant number: CB-2011-02-01) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (grant number: 2011-0022379).

Conflicts of interest

None.

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Sang Min Lee
    • 1
    • 2
  • Chang Min Park
    • 1
    • 2
  • Jin Chul Paeng
    • 3
  • Hyung Jun Im
    • 3
  • Jin Mo Goo
    • 1
    • 2
  • Hyun-Ju Lee
    • 1
    • 2
  • Chang Hyun Kang
    • 4
  • Young Whan Kim
    • 5
  • Jung Im Kim
    • 6
  1. 1.Department of RadiologySeoul National University College of MedicineSeoulKorea
  2. 2.Institute of Radiation MedicineSeoul National University Medical Research CenterSeoulKorea
  3. 3.Department of Nuclear MedicineSeoul National University College of MedicineSeoulKorea
  4. 4.Department of Thoracic and Cardiovascular SurgerySeoul National University College of MedicineSeoulKorea
  5. 5.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung InstituteSeoul National University College of MedicineSeoulKorea
  6. 6.Seoul National University HospitalHealthcare Gangnam CenterSeoulKorea

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