Aims and objectives
In patients with non-small lung cancer,
N-staging is often performed by using Positron emission tomography/ integrated computed tomography (PET/CT) .
the diagnostic accuracy of maximum standardized uptake value (SUVmax) for mediastinal lymph nodes is not always accurate due to indeterminate PET findings.
In the present study,
we investigated whether the combination of 18F-FDG uptake and LN density based on CT histogram analysis can be used to further enhance the ability of 18F-FDG...
Methods and materials
78 patients with 556 mediastinal LNs who underwent PET/CT and systemic LN resection with 30 days were enrolled. In this study,
the clinical standard for evaluating LNs on 18F-FDG PET/CT is to classify them as PET postive (PET+) when the SUVmax is more than 3 times that of the blood pool,
and PET indeterminate ( PET +/-) when 1-3 times that of the boood pool,
and PET negative (PET-) when less than or equal to that of that blood pool. We compared Maximum standardized uptake value (SUVmax),...
Of 556 nodes,
78 (14.03% ) were malignant.
The mean value of SUVmax,
short axis diameter,
SUVindex of malignant LNs were higher than those of benign nodes.
LNs with positive SUV-uptake had significantly higher CT values compared to PET-negative LN.
Benign nodules had values <20HU.
Using a threshold of 3.4 for SUVmax,
0.32 for SUVn/t and 1.11 for SUVindex yield sensitivities of 57%,
71% and 65% and specities of 71% ,
69% ,78% respectively for the detection of metastasis LNs.
LN density may be complimentary to conventional visual interpretation of LNs with mild 18F-FDG uptake.
DJ Kim ,
The diagnositc ability of 18F-FDG PET/CT for mediastinal lymph node staging using 18F-FDG uptake and volumetric CT histogram analysis in non-small cell lung cancer.
Eur Radiol,2016,26:4515-4523. 2.
P Frank ,C Kratochwil,
Radiomic analysis using density threshold for FDG-PET/CT-based N-Staging in Lung cancer patients.
Mol Imaging Biol,2017,19(2):315-322. 3.
FL Giesel ,
Correlation between SUVmax and CT...