title: Is there any maximum standardized uptake value variation among positron emission tomography scanners for mediastinal staging in non-small cell lung cancer?
abstract: The maximum standardized uptake value (SUV(max)) varies among positron emission tomography-integrated computed tomography (PET/CT) centers in the staging of non-small cell lung cancer. We evaluated the ratio of the optimum SUV(max) cut-off for the lymph nodes to the median SUV(max) of the primary tumor (ratioSUV(max)) to determine SUV(max) variations between PET/CT scanners. The previously described PET predictive ratio (PPR) was also evaluated. PET/CT and mediastinoscopy and/or thoracotomy were performed on 337 consecutive patients between September 2005 and March 2009. Thirty-six patients were excluded from the study. The pathological results were correlated with the PET/CT findings. Histopathological examination was performed on 1136 N2 lymph nodes using 10 different PET/CT centers. The majority of patients (group A: 240) used the same PET/CT scanner at four different centers. Others patients were categorized as group B. The ratioSUV(max) for groups A and B was 0.18 and 0.22, respectively. The same ratio for centers 1, 2, 3 and 4 was 0.2, 0.21, 0.21, and 0.23, respectively. The optimal cut-off value of the PPR to predict mediastinal lymph node pathology for malignancy was 0.49 (likelihood ratio +2.02; sensitivity 70%, specificity 65%). We conclude that the ratioSUV(max) was similar for different scanners. Thus, SUV(max) is a valuable cut-off for comparing-centers.
authors: Department of Thoracic Surgery, Cizre Dr. Selahattin Cizrelioglu State Hospital, Sirnak, Turkey. ilker.iskender@yahoo.ca
authors: Ilker
authors: I
authors: Iskender
authors: Salih Zeki
authors: SZ
authors: Kadioglu
authors: Altug
authors: A
authors: Kosar
authors: Ali
authors: A
authors: Atasalihi
authors: Altan
authors: A
authors: Kir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000556:secondary; D004867:Equipment Design; 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; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000592:standards*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014421:Turkey
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18