Comparative efficacy of positron emission tomography with fluorodeoxyglucose in evaluation of small (<1 cm), intermediate (1 to 3 cm), and large (>3 cm) lymph node lesions.
OBJECTIVE
Our objective was to determine if positron emission tomography (PET) with fluorodeoxyglucose (FDG; PET-FDG) imaging is equally efficacious in detection of metastases in small and large mediastinal lymph nodes as compared to CT scanning.


METHODS
PET-FDG imaging, CT scanning, and histology results of sampled mediastinal lymph nodes were compared in 54 patients of total 118 patients studied. Efficacy of PET and CT was determined and compared in small (< 1 cm), intermediate (1 to 3 cm), and large (> 3 cm) mediastinal lesions.


RESULTS
PET was accurate in 94% of patients in characterizing "N" disease as compared to 61% with CT. Overall, sensitivity, specificity, and accuracy of PET for staging mediastinal lymph nodes (n = 168 in 54 patients) was 96, 93, and 94%, as compared to 68, 65, and 66% with CT. Positive and negative predictive value of PET in detecting mediastinal adenopathy was 86% and 98%, as compared to 47% and 82% with CT, respectively. PET was also highly reliable and accurate for detecting lymph nodes < 1 cm, 1 to 3 cm, and > 3 cm in size with superior efficacy than CT. Sensitivity, specificity, and accuracy of PET for detecting malignancy in lymph node lesions < 1 cm in size was 97, 82, and 95%, respectively.


CONCLUSIONS
PET-FDG imaging is equally reliable and accurate for detecting disease in small and large lymph node lesions in patients with suspected or proven lung cancer with better efficacy than CT.
Gupta
N C
NC
West Virginia University PET Center and Department of Surgery, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA. ngupta@wvu.edu
Graeber
G M
GM
Bishop
H A
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18