FDG-PET/CT in patients with pulmonary cancer: quantitative analyses for improved detection of lymph node metastases
- Conditions
- C34Malignant neoplasm of bronchus and lung
- Registration Number
- DRKS00012624
- Lead Sponsor
- niversitätsklinikum Magdeburg
- Brief Summary
Purpose: Pre-operative assessment of thoracic lymphonodal (LN) involvement in patients with lung cancer (LC) is crucial when choosing the treatment modality. Visual assessment of F-18-FDG-PET/CT (PET/CT) is well established, however, there is still a need for prospective quantitative data to differentiate benign from malignant lesions which would simplify staging and guide the further implementation of computer-aided diagnosis (CAD). Methods: In this prospective study, 37 patients with confirmed lung cancer (m/f = 24/13; age: 70 [52-83] years) were analyzed. All patients underwent PET/CT and quantitative data (standardized uptake values) were obtained. Histological results were available for 101 thoracic lymph nodes. Quantitative data were matched to determine cut-off values for delineation between benign vs. malignant lymph nodes. Furthermore, a scoring system derived from these cut-off values was established. Statistical analyses were performed through ROC analysis. Results: Quantitative analysis revealed the optimal cut-off values (p < 0.01) for the differentiation between benign and malignant thoracic lymph nodes in patients suffering from lung cancer. The respective areas under the curve (AUC) ranged from 0.86 to 0.94. The highest AUC for a ratio of lymph node to healthy lung tissue was 0.94. The resulting accuracy ranged from 78.2% to 89.1%. A dedicated scoring system led to an AUC of 0.93 with a negative predictive value of 95.4%. Conclusion: Quantitative analysis of F-18-FDG-PET/CT data provides reliable results for delineation between benign and malignant thoracic lymph nodes. Thus, quantitative parameters can improve diagnostic accuracy and reliability and can also facilitate the handling of the steadily increasing number of clinical examinations.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 73
FDG-PET/CT for primary staging of pulmonary cancer, informed consent, age > 18 years, sufficient histological information
non-existence of informed consent, withdrawal of informed consent, missing histology, pregnancy
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Definition of quantitative parameters to distinguish benign vs. Malignant glucose changes in mediastinal and hilary lymph nodes<br><br>The reference standard is histology. On the basis of this an optimal separation value (malignant vs. benign) is to be determined
- Secondary Outcome Measures
Name Time Method definition of quantitative parameters for predicting outcome after systemic therapy (if conducted)