Mediastinal lymph nodes staging by 18F-FDG PET/CT for early stage non-small cell lung cancer: A multicenter study

Li, Xiaolin; Zhang, Huaqi; Xing, Ligang; Ma, Honglian; Xie, Peng; Zhang, Lin; Xu, Xiangying; Yue, Jinbo; Sun, Xindong; Hu, Xudong; Chen, Ming; Xu, Wengui; Chen, Lusheng; Yu, Jinming

doi:10.1016/j.radonc.2011.10.016

« Previous Next »Radiotherapy & Oncology
Volume 102, Issue 2 , Pages 246-250, February 2012

Mediastinal lymph nodes staging by ¹⁸F-FDG PET/CT for early stage non-small cell lung cancer: A multicenter study

Xiaolin Li
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
- These authors equally contributed to the study.
Huaqi Zhang
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
- These authors equally contributed to the study.
Ligang Xing
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
Honglian Ma
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
Peng Xie
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
Lin Zhang
- Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
Xiangying Xu
- Department of Radiation Oncology, Tumor Hospital Affiliated to Harbin Medical University, China
Jinbo Yue
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
Xindong Sun
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
Xudong Hu
- Department of Nuclear Medicine, Shandong Tumor Hospital and Institute, Jinan, China
Ming Chen
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
Wengui Xu
- Department of Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, China
Lusheng Chen
- Department of Nuclear Medicine, Shandong Tumor Hospital and Institute, Jinan, China
Jinming Yu
- Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China
- Corresponding author. Address: Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jiyan Road 440, Jinan 250117, Shandong Province, China.

Received 31 May 2011; received in revised form 19 October 2011; accepted 20 October 2011. published online 21 November 2011.

Abstract

Purpose

Accurate staging of mediastinal lymph nodes metastases is critical for determining the application of stereotactic body radiation therapy (SBRT) for patients with early stage non-small cell lung cancer (NSCLC). In this multicenter study the accuracy of ¹⁸F-FDG PET/CT to detect lymph node metastases was evaluated for early stage NSCLC.

Materials and methods

The data from the patients with stage1 NSCLC who received preoperative ¹⁸F-FDG PET/CT staging and radical surgery was retrospectively reviewed of five centers from February 2004 to August 2010. The lymph node metastases were confirmed histopathologically after radical surgery. And the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for PET/CT staging.

Results

Two hundred patients were enrolled. The sensitivity, specificity, accuracy, PPV and NPV for lymph node metastases on PET/CT were 44%, 83%, 78%, 29% and 91%, respectively. There were eight and 19 cases positive for lymph node metastases with central (n=62) and peripheral (n=138) NSCLC (P>0.05), respectively.

Conclusion

¹⁸F-FDG PET/CT was specific in N₀ staging for T_1–2 NSCLC. The NPV was about 91% in clinical N₀ patients, suggested that ¹⁸F-FDG PET/CT may help to accurately stage N₀ patients and thus identify patients for SBRT.

Keywords: ¹⁸F-FDG PET/CT, Stage I, NSCLC, Lymph node, SBRT