Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan
Objective To clarify the difference of 18 F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for diff...
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| Veröffentlicht in: | Annals of nuclear medicine 2009-08, Vol.23 (6), p.523-531 |
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| creator | Suga, Kazuyoshi Kawakami, Yasuhiko Hiyama, Atsuto Sugi, Kazurou Okabe, Kazutomo Matsumoto, Tsuneo Ueda, Kazuhiro Tanaka, Nobuyuki Matsunaga, Naofumi |
| description | Objective
To clarify the difference of
18
F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.
Methods
The subjects were 134 FDG-avid metastatic LNs in 67 patients with NSCLC and 62 FDG-avid benign LNs in 61 patients with various lung disorders including NSCLC. PET/CT scan was performed at 2 time points (at 60 min and at 120 min) after intravenous injection of 4.4 MBq/kg
18
F-FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax) were measured at each FDG-avid LN. The optimal parameter for differentiation was determined by the receiver-operating characteristic analysis.
Results
Delayed SUVmax was increased compared with early SUVmax in 114 (85.0%) FDG-avid metastatic LNs and 42 (67.7%) FDG-avid benign LNs, with significant higher delayed SUVmax than early values (7.0 ± 5.0 vs. 5.9 ± 3.4;
P
3.0 alone (
P
= 0.019) or the optimal parameter for %ΔSUVmax (>5%) (
P
= 0.012). However, 12 (19.3%) benign LNs were indistinguishable from metastatic LNs.
Conclusions
Although dual-time point PET/CT scan enhances the difference of FDG uptake between FDG-avid metastatic and benign LNs and improves the differentiation when compared with a single scan, biopsy procedure may be still required for accurate assessment of LN status in patients with NSCLC and possible etiologies showing intensive FDG uptake in benign LNs. |
| doi_str_mv | 10.1007/s12149-009-0268-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_215041428</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1895462931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c250y-d73a51456c360adce161734cded760298ab7977d029c3fabfc8055f1a7ae738a3</originalsourceid><addsrcrecordid>eNp1kL1OAzEQhC0EEuHnAegsehPb92OnRIEAEhIUobY29l5wdOcL9gV0b8Ej4yhIVBS7O8XMrPQRciX4jeBcTZOQopwxzvPIWrPxiEyErktWl0VxTCZ8JkqmhFan5CylDedSV1pOyPedbxqMGAYPLXUe1qFPPtEVDl-IgQq9YIu7Bwaf3tEOB0gDDN7Sduy27zT0DhP1IYvAUgdtSy3m1e7CmloIFiOF4HJb8Ovwa-8DdTto2eA7pNveh4G-3i-n8yVNOXJBThpoE17-3nPytrhfzh_Z88vD0_z2mVlZ8ZE5VUAlyqq2Rc3BWRS1UEVpHTpVcznTsFIzpVyWtmhg1VjNq6oRoABVoaE4J9eH3m3sP3aYBrPpdzHkl0aKipeilDqbxMFkY59SxMZso-8gjkZws-duDtxN5m723M2YM_KQSdkb1hj_iv8P_QBZtIb6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>215041428</pqid></control><display><type>article</type><title>Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan</title><source>SpringerLink Journals - AutoHoldings</source><creator>Suga, Kazuyoshi ; Kawakami, Yasuhiko ; Hiyama, Atsuto ; Sugi, Kazurou ; Okabe, Kazutomo ; Matsumoto, Tsuneo ; Ueda, Kazuhiro ; Tanaka, Nobuyuki ; Matsunaga, Naofumi</creator><creatorcontrib>Suga, Kazuyoshi ; Kawakami, Yasuhiko ; Hiyama, Atsuto ; Sugi, Kazurou ; Okabe, Kazutomo ; Matsumoto, Tsuneo ; Ueda, Kazuhiro ; Tanaka, Nobuyuki ; Matsunaga, Naofumi</creatorcontrib><description>Objective
To clarify the difference of
18
F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.
Methods
The subjects were 134 FDG-avid metastatic LNs in 67 patients with NSCLC and 62 FDG-avid benign LNs in 61 patients with various lung disorders including NSCLC. PET/CT scan was performed at 2 time points (at 60 min and at 120 min) after intravenous injection of 4.4 MBq/kg
18
F-FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax) were measured at each FDG-avid LN. The optimal parameter for differentiation was determined by the receiver-operating characteristic analysis.
Results
Delayed SUVmax was increased compared with early SUVmax in 114 (85.0%) FDG-avid metastatic LNs and 42 (67.7%) FDG-avid benign LNs, with significant higher delayed SUVmax than early values (7.0 ± 5.0 vs. 5.9 ± 3.4;
P
< 0.0001, and 3.0 ± 1.3 vs. 2.8 ± 1.0;
P
< 0.05, respectively). Early and delayed SUVmax and %ΔSUVmax in metastatic LNs were significantly higher than those in benign LNs (
P
< 0.0001). The optimal parameter for the differentiation was the combined use of early SUVmax > 3.0 or delayed SUVmax > 4.0, yielding sensitivity of 88.8%, specificity of 80.6%, accuracy of 86.2%, negative predictive value of 76.9%, and positive predictive value of 90.6%. It provided better results than the use of early SUVmax > 3.0 alone (
P
= 0.019) or the optimal parameter for %ΔSUVmax (>5%) (
P
= 0.012). However, 12 (19.3%) benign LNs were indistinguishable from metastatic LNs.
Conclusions
Although dual-time point PET/CT scan enhances the difference of FDG uptake between FDG-avid metastatic and benign LNs and improves the differentiation when compared with a single scan, biopsy procedure may be still required for accurate assessment of LN status in patients with NSCLC and possible etiologies showing intensive FDG uptake in benign LNs.</description><identifier>ISSN: 0914-7187</identifier><identifier>EISSN: 1864-6433</identifier><identifier>DOI: 10.1007/s12149-009-0268-y</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Imaging ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Original Article ; Radiology</subject><ispartof>Annals of nuclear medicine, 2009-08, Vol.23 (6), p.523-531</ispartof><rights>The Japanese Society of Nuclear Medicine 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c250y-d73a51456c360adce161734cded760298ab7977d029c3fabfc8055f1a7ae738a3</citedby><cites>FETCH-LOGICAL-c250y-d73a51456c360adce161734cded760298ab7977d029c3fabfc8055f1a7ae738a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12149-009-0268-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12149-009-0268-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids></links><search><creatorcontrib>Suga, Kazuyoshi</creatorcontrib><creatorcontrib>Kawakami, Yasuhiko</creatorcontrib><creatorcontrib>Hiyama, Atsuto</creatorcontrib><creatorcontrib>Sugi, Kazurou</creatorcontrib><creatorcontrib>Okabe, Kazutomo</creatorcontrib><creatorcontrib>Matsumoto, Tsuneo</creatorcontrib><creatorcontrib>Ueda, Kazuhiro</creatorcontrib><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Matsunaga, Naofumi</creatorcontrib><title>Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan</title><title>Annals of nuclear medicine</title><addtitle>Ann Nucl Med</addtitle><description>Objective
To clarify the difference of
18
F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.
Methods
The subjects were 134 FDG-avid metastatic LNs in 67 patients with NSCLC and 62 FDG-avid benign LNs in 61 patients with various lung disorders including NSCLC. PET/CT scan was performed at 2 time points (at 60 min and at 120 min) after intravenous injection of 4.4 MBq/kg
18
F-FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax) were measured at each FDG-avid LN. The optimal parameter for differentiation was determined by the receiver-operating characteristic analysis.
Results
Delayed SUVmax was increased compared with early SUVmax in 114 (85.0%) FDG-avid metastatic LNs and 42 (67.7%) FDG-avid benign LNs, with significant higher delayed SUVmax than early values (7.0 ± 5.0 vs. 5.9 ± 3.4;
P
< 0.0001, and 3.0 ± 1.3 vs. 2.8 ± 1.0;
P
< 0.05, respectively). Early and delayed SUVmax and %ΔSUVmax in metastatic LNs were significantly higher than those in benign LNs (
P
< 0.0001). The optimal parameter for the differentiation was the combined use of early SUVmax > 3.0 or delayed SUVmax > 4.0, yielding sensitivity of 88.8%, specificity of 80.6%, accuracy of 86.2%, negative predictive value of 76.9%, and positive predictive value of 90.6%. It provided better results than the use of early SUVmax > 3.0 alone (
P
= 0.019) or the optimal parameter for %ΔSUVmax (>5%) (
P
= 0.012). However, 12 (19.3%) benign LNs were indistinguishable from metastatic LNs.
Conclusions
Although dual-time point PET/CT scan enhances the difference of FDG uptake between FDG-avid metastatic and benign LNs and improves the differentiation when compared with a single scan, biopsy procedure may be still required for accurate assessment of LN status in patients with NSCLC and possible etiologies showing intensive FDG uptake in benign LNs.</description><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>Radiology</subject><issn>0914-7187</issn><issn>1864-6433</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kL1OAzEQhC0EEuHnAegsehPb92OnRIEAEhIUobY29l5wdOcL9gV0b8Ej4yhIVBS7O8XMrPQRciX4jeBcTZOQopwxzvPIWrPxiEyErktWl0VxTCZ8JkqmhFan5CylDedSV1pOyPedbxqMGAYPLXUe1qFPPtEVDl-IgQq9YIu7Bwaf3tEOB0gDDN7Sduy27zT0DhP1IYvAUgdtSy3m1e7CmloIFiOF4HJb8Ovwa-8DdTto2eA7pNveh4G-3i-n8yVNOXJBThpoE17-3nPytrhfzh_Z88vD0_z2mVlZ8ZE5VUAlyqq2Rc3BWRS1UEVpHTpVcznTsFIzpVyWtmhg1VjNq6oRoABVoaE4J9eH3m3sP3aYBrPpdzHkl0aKipeilDqbxMFkY59SxMZso-8gjkZws-duDtxN5m723M2YM_KQSdkb1hj_iv8P_QBZtIb6</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Suga, Kazuyoshi</creator><creator>Kawakami, Yasuhiko</creator><creator>Hiyama, Atsuto</creator><creator>Sugi, Kazurou</creator><creator>Okabe, Kazutomo</creator><creator>Matsumoto, Tsuneo</creator><creator>Ueda, Kazuhiro</creator><creator>Tanaka, Nobuyuki</creator><creator>Matsunaga, Naofumi</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20090801</creationdate><title>Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan</title><author>Suga, Kazuyoshi ; Kawakami, Yasuhiko ; Hiyama, Atsuto ; Sugi, Kazurou ; Okabe, Kazutomo ; Matsumoto, Tsuneo ; Ueda, Kazuhiro ; Tanaka, Nobuyuki ; Matsunaga, Naofumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c250y-d73a51456c360adce161734cded760298ab7977d029c3fabfc8055f1a7ae738a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Original Article</topic><topic>Radiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suga, Kazuyoshi</creatorcontrib><creatorcontrib>Kawakami, Yasuhiko</creatorcontrib><creatorcontrib>Hiyama, Atsuto</creatorcontrib><creatorcontrib>Sugi, Kazurou</creatorcontrib><creatorcontrib>Okabe, Kazutomo</creatorcontrib><creatorcontrib>Matsumoto, Tsuneo</creatorcontrib><creatorcontrib>Ueda, Kazuhiro</creatorcontrib><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Matsunaga, Naofumi</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest research library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Annals of nuclear medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suga, Kazuyoshi</au><au>Kawakami, Yasuhiko</au><au>Hiyama, Atsuto</au><au>Sugi, Kazurou</au><au>Okabe, Kazutomo</au><au>Matsumoto, Tsuneo</au><au>Ueda, Kazuhiro</au><au>Tanaka, Nobuyuki</au><au>Matsunaga, Naofumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan</atitle><jtitle>Annals of nuclear medicine</jtitle><stitle>Ann Nucl Med</stitle><date>2009-08-01</date><risdate>2009</risdate><volume>23</volume><issue>6</issue><spage>523</spage><epage>531</epage><pages>523-531</pages><issn>0914-7187</issn><eissn>1864-6433</eissn><abstract>Objective
To clarify the difference of
18
F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.
Methods
The subjects were 134 FDG-avid metastatic LNs in 67 patients with NSCLC and 62 FDG-avid benign LNs in 61 patients with various lung disorders including NSCLC. PET/CT scan was performed at 2 time points (at 60 min and at 120 min) after intravenous injection of 4.4 MBq/kg
18
F-FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax) were measured at each FDG-avid LN. The optimal parameter for differentiation was determined by the receiver-operating characteristic analysis.
Results
Delayed SUVmax was increased compared with early SUVmax in 114 (85.0%) FDG-avid metastatic LNs and 42 (67.7%) FDG-avid benign LNs, with significant higher delayed SUVmax than early values (7.0 ± 5.0 vs. 5.9 ± 3.4;
P
< 0.0001, and 3.0 ± 1.3 vs. 2.8 ± 1.0;
P
< 0.05, respectively). Early and delayed SUVmax and %ΔSUVmax in metastatic LNs were significantly higher than those in benign LNs (
P
< 0.0001). The optimal parameter for the differentiation was the combined use of early SUVmax > 3.0 or delayed SUVmax > 4.0, yielding sensitivity of 88.8%, specificity of 80.6%, accuracy of 86.2%, negative predictive value of 76.9%, and positive predictive value of 90.6%. It provided better results than the use of early SUVmax > 3.0 alone (
P
= 0.019) or the optimal parameter for %ΔSUVmax (>5%) (
P
= 0.012). However, 12 (19.3%) benign LNs were indistinguishable from metastatic LNs.
Conclusions
Although dual-time point PET/CT scan enhances the difference of FDG uptake between FDG-avid metastatic and benign LNs and improves the differentiation when compared with a single scan, biopsy procedure may be still required for accurate assessment of LN status in patients with NSCLC and possible etiologies showing intensive FDG uptake in benign LNs.</abstract><cop>Japan</cop><pub>Springer Japan</pub><doi>10.1007/s12149-009-0268-y</doi><tpages>9</tpages></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Imaging Medicine Medicine & Public Health Nuclear Medicine Original Article Radiology |
| title | Differential diagnosis between 18F-FDG-avid metastatic lymph nodes in non-small cell lung cancer and benign nodes on dual-time point PET/CT scan |
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