Mediastinal staging of non-small cell lung carcinoma using computed and positron-emission tomography.
BACKGROUND
We evaluated the accuracy of computed tomography (CT) and positron-emission tomography (PET) in the mediastinal staging of non-small cell lung cancer.


METHODS
Between May 14, 1999, and November 28, 2000, computerized tomography (CT) and positron-emission tomography (PET) were used to clinically stage 94 consecutive patients with non-small cell carcinoma of the lung (NSCCL). All patients underwent subsequent surgical staging with mediastinoscopy, anterior mediastinotomy, and/or thoracotomy with mediastinal lymphadenectomy.


RESULTS
Overall accuracy was the same for both procedures. False-negative results occurred 3 times more often with CT; false-positive results occurred twice as often with PET. Sensitivity and specificity were 64% and 94%, respectively, for CT, versus 88% and 86%, respectively, for PET. Positive and negative predictive values were 80% and 88%, respectively, for CT, versus 71% and 95%, respectively, for PET.


CONCLUSIONS
In addition to routine use of CT, PET seems to achieve high negative predictive value in the evaluation of mediastinal disease; PET seems particularly helpful in assessing absence of tumor in bulky nodes after neoadjuvant chemotherapy and/or radiotherapy.
Kiernan
Paul D
PD
Department of Medicine, Inova Fairfax Hospital, VA, USA.
Sheridan
Michael J
MJ
Lamberti
James
J
Dicicco
Barry
B
Wigton
Roger
R
Hetrick
Vivian
V
Vaughan
Betty
B
Graling
Paula
P
D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008482:Mediastinum / Q000473:pathology*; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed