title: Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT.
abstract: OBJECTIVE
  To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT.
  
  
  METHODS
  PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1h, and on delayed scans (SUVd) 2h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p<0.05 was considered statistically significant.
  
  
  RESULTS
  Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation.
  
  
  CONCLUSIONS
  Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.
authors.affiliation: Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677, Japan. takaby@hotmail.com
authors.forename: Takami
authors.initials: T
authors.lastname: Kasai
authors.forename: Ken
authors.initials: K
authors.lastname: Motoori
authors.forename: Takuro
authors.initials: T
authors.lastname: Horikoshi
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasufuku
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takiguchi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Takahashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kuniyasu
authors.forename: Hisao
authors.initials: H
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D016081:Moon; D049268:Positron-Emission Tomography / Q000379:methods; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18