title: Value of dual-time-point FDG PET/CT for mediastinal nodal staging in non-small-cell lung cancer patients with lung comorbidity.
abstract: OBJECTIVE
  To evaluate the efficacy of dual-time-point F-18 fluorodeoxyglucose positron emission tomography (FDG PET)/ computed tomography (CT) for mediastinal nodal staging in non-small-cell lung cancer patients with lung comorbidity.
  
  
  METHODS
  Fifty-three pathologically proven non-small-cell lung cancer patients with pulmonary comorbidity and 49 patients as controlled group without comorbidity were enrolled. PET/CT was performed at 1-hour (whole body) post-FDG injection and repeated 2 hours (thoracic) after injection. All patients received radical surgery with system mediastinal lymph node (LN) dissection. The results of LN detection by single-time-point and dual-time-point scan were compared with the histopathologic findings.
  
  
  RESULTS
  On a per-patient basis, in patients with pulmonary comorbidity, the sensitivity, specificity, accuracy, and positive predictive values (PPV), and negative predictive values of single-time-point scan were 87.5%, 59.5%, 67.9%, 48.3%, and 91.7%, respectively. Those values of dual-time-point scan were 93.8%, 67.6%, 75.5%, 55.6%, and 96.2%, respectively. In patients without comorbidity, dual-time-point scan was similar in those values to single-time-point. On a per-nodal station basis, the specificity, accuracy, and PPV of dual-time-point scan were better than those of single-time-point with statistically significant differences (P = 0.017, 0.002, and 0.027, respectively) in patients with pulmonary comorbidity, but the difference was not statistically significant in patients with no pulmonary comorbidity.
  
  
  CONCLUSIONS
  Dual-time-point FDG PET/CT is more effective for mediastinal nodal staging than single-time-point in patients with pulmonary comorbidity. Dual-time-point scan was useful for diagnosis of mediastinal LN metastases in reducing the false-positive results in all patients, but improved specificity, accuracy, and PPV only in patients with pulmonary comorbidity.
authors.affiliation: Department of Radiation Oncology and Shandong Province Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
authors.forename: Man
authors.initials: M
authors.lastname: Hu
authors.forename: Anqin
authors.initials: A
authors.lastname: Han
authors.forename: Ligang
authors.initials: L
authors.lastname: Xing
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Yang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Fu
authors.forename: Chengsuo
authors.initials: C
authors.lastname: Huang
authors.forename: Pinliang
authors.initials: P
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Kong
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000150:complications; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18