Mediastinal staging of non-small-cell lung cancer with positron emission tomography

R. Chin, R. Ward, J. W. Keyes, Robert Choplin, J. C. Reed, S. Wallenhaupt, A. S. Hudspeth, E. F. Haponik

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

To determine the usefulness of positron emission tomography with fluoro- 2-deoxyglucose (PET-FDG) in assessing mediastinal disease in patients with non-small-cell lung cancer (NSCLC) and to compare its yield to that of computed tomography (CT), we performed a prospective consecutive sample investigation in a university hospital and its related clinics. In 30 patients with NSCLC with clinical stage I (T1-2, N0, M0) disease, we compared the results of chest CT and PET-FDG with the findings at surgical exploration of the mediastinum. Seven (77%) of nine patients with surgically proven mediastinal metastasis were identified by the PET-FDG results, with four false-positives in 21 patients with negative lymphnode dissections (p = 0.004). Using the results of pathologic examination of mediastinal lymph nodes as the criterion standard, the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for PET-FDG imaging of mediastinal metastases were 78%, 81%, 80%, 64%, and 89%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV for chest CT in the detection of mediastinal metastasis were 56%, 86%, 77%, 63%, and 87%, respectively. CT and PET-FDG results agreed in 21 patients. The diagnostic accuracy of the combined imaging modalities was 90%. We concluded that mediastinal uptake of FDG correlates with the extent of mediastinal involvement of NSCLC and may contribute to preoperative staging. PET-FDG imaging complements chest CT in the noninvasive evaluation of NSCLC, and strategies for its use merit further investigation.

Original languageEnglish (US)
Pages (from-to)2090-2096
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume152
Issue number6 I
StatePublished - 1995
Externally publishedYes

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Deoxyglucose
Non-Small Cell Lung Carcinoma
Positron-Emission Tomography
Thorax
Tomography
Neoplasm Metastasis
Mediastinal Diseases
Sensitivity and Specificity
Mediastinum
Dissection
Lymph Nodes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Chin, R., Ward, R., Keyes, J. W., Choplin, R., Reed, J. C., Wallenhaupt, S., ... Haponik, E. F. (1995). Mediastinal staging of non-small-cell lung cancer with positron emission tomography. American Journal of Respiratory and Critical Care Medicine, 152(6 I), 2090-2096.

Mediastinal staging of non-small-cell lung cancer with positron emission tomography. / Chin, R.; Ward, R.; Keyes, J. W.; Choplin, Robert; Reed, J. C.; Wallenhaupt, S.; Hudspeth, A. S.; Haponik, E. F.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 152, No. 6 I, 1995, p. 2090-2096.

Research output: Contribution to journalArticle

Chin, R, Ward, R, Keyes, JW, Choplin, R, Reed, JC, Wallenhaupt, S, Hudspeth, AS & Haponik, EF 1995, 'Mediastinal staging of non-small-cell lung cancer with positron emission tomography', American Journal of Respiratory and Critical Care Medicine, vol. 152, no. 6 I, pp. 2090-2096.
Chin, R. ; Ward, R. ; Keyes, J. W. ; Choplin, Robert ; Reed, J. C. ; Wallenhaupt, S. ; Hudspeth, A. S. ; Haponik, E. F. / Mediastinal staging of non-small-cell lung cancer with positron emission tomography. In: American Journal of Respiratory and Critical Care Medicine. 1995 ; Vol. 152, No. 6 I. pp. 2090-2096.
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