title: Integrated positron-emission tomography for nodal staging in lung cancer.
abstract: As lymph node metastasis is the most important factor determining the surgical outcome of lung cancer, we evaluated the accuracy and clinical usefulness of functional imaging with integrated positron-emission tomography and computed tomography in nodal staging of non-small-cell lung cancer. Between October 2003 and August 2004, 43 newly diagnosed patients underwent curative surgical resection or mediastinoscopic nodal biopsy after chest computed tomography as well as whole-body functional imaging for clinical staging. Based on histopathologic findings in the lymph nodes, we compared the diagnostic usefulness of computed tomography and functional imaging. Twenty-two patients were N0 stage, 6 were N1, 11 were N2, and 4 were N3. Although functional imaging seemed to be superior for evaluation of N2 nodes, there were no significant differences in the sensitivity, specificity, positive-predictive value, negative-predictive value, or accuracy. The situation was similar for N1 nodes, and there were no significant differences except for the false-negative rate. High false-positive and negative-rates for N2 lymph nodes suggest that functional imaging should not replace mediastinoscopy.
authors.affiliation: Seoul National University Hospital, Seoul, South Korea. ytkim@snu.ac.kr
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Kang
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kang
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed