title: [Density and SUV ratios from PET/CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer].
abstract: OBJECTIVE
  Mediastinal involvement in lung cancer is a highly significant prognostic factor for survival, and accurate staging of the mediastinum will correctly identify patients who will benefit the most from surgery. Positron emission tomography/computed tomography (PET/CT) has become the standard imaging modality for the staging of patients with lung cancer. The aim of this study is to investigate 18-fluoro-2-deoxy-glucose (18F-FDG) PET/CT imaging in the detection of mediastinal disease in lung cancer.
  
  
  METHODS
  A total of 72 patients newly diagnosed with non-small cell lung cancer (NSCLC) who underwent preoperative whole-body 18F-FDG PET/CT were retrospectively included. All patients underwent radical surgery and mediastinal lymph node dissection. Mediastinal disease was histologically confirmed in 45 of 413 lymph nodes. PET/CT doctors analyzed patients' visual images and evaluated lymph node's short axis, lymph node's maximum standardized uptake value (SUVmax), node/aorta density ratio, node/aorta SUV ratio, and other parameters using the histopathological results as the reference standard. The optimal cutoff value for each ratio was determined by receiver operator characteristic curve analysis.
  
  
  RESULTS
  Using a threshold of 0.9 for density ratio and 1.2 for SUV ratio yielded high accuracy for the detection of mediastinal disease. The lymph node's short axis, lymph node's SUVmax, density ratio, and SUV ratio of integrated PET/CT for the accuracy of diagnosing mediastinal lymph node was 95.2%. The diagnostic accuracy of mediastinal lymph node with conventional PET/CT was 89.8%, whereas that of PET/CT comprehensive analysis was 90.8%.
  
  
  CONCLUSIONS
  Node/aorta density ratio and SUV ratio may be complimentary to conventional visual interpretation and SUVmax measurement. The use of lymph node's short axis, lymph node's SUVmax, and both ratios in combination is better than either conventional PET/CT analysis or PET/CT comprehensive analysis in the assessment of mediastinal disease in NSCLC patients. .
authors: Department of PET/CT-MRI, Harbin Medical University Cancer Hospital, Harbin 150081, China.
authors: Tingting
authors: T
authors: Shao
authors: Department of PET/CT-MRI, Harbin Medical University Cancer Hospital, Harbin 150081, China.
authors: Lijuan
authors: L
authors: Yu
authors: Department of PET/CT-MRI, Harbin Medical University Cancer Hospital, Harbin 150081, China.
authors: Yingci
authors: Y
authors: Li
authors: Department of PET/CT-MRI, Harbin Medical University Cancer Hospital, Harbin 150081, China.
authors: Munan
authors: M
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18