Utility of FDG PET/CT for Preoperative Staging of Non-Small Cell Lung Cancers Manifesting as Subsolid Nodules With a Solid Portion of 3 cm or Smaller
The objective of our study was to investigate the utility of FDG PET/CT for the preoperative staging of subsolid non-small cell lung cancers (NSCLCs) with a solid portion size of 3 cm or smaller. We retrospectively enrolled 855 patients with pathologically proven NSCLCs manifesting as subsolid nodul...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2020-03, Vol.214 (3), p.514-523 |
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| container_title | American journal of roentgenology (1976) |
| container_volume | 214 |
| creator | Suh, Young Joo Park, Chang Min Han, Kyunghwa Jeon, Sun Kyung Kim, Hyungjin Hwang, Eui Jin Lee, Jong Hyuk Paeng, Jin Chul Lee, Chang Hoon Kim, Young Tae Goo, Jin Mo |
| description | The objective of our study was to investigate the utility of FDG PET/CT for the preoperative staging of subsolid non-small cell lung cancers (NSCLCs) with a solid portion size of 3 cm or smaller.
We retrospectively enrolled 855 patients with pathologically proven NSCLCs manifesting as subsolid nodules with a solid portion of 3 cm or smaller on CT. We then compared the diagnostic performances of FDG PET/CT and chest CT for detecting lymph node (LN), intrathoracic, or distant metastases in patients who underwent preoperative chest CT and FDG PET/CT. After propensity score matching, we compared the diagnostic performance of FDG PET/CT in the group who underwent both chest CT and FDG PET/CT with that of chest CT in patients who did not undergo FDG PET/CT.
There were LN metastases in 25 of 765 patients (3.3%) who underwent surgical LN dissection or biopsy and intrathoracic or distant metastasis in two of 855 patients (0.2%). For LN staging, FDG PET/CT showed a sensitivity of 44.0%, specificity of 81.5%, positive predictive value of 9.6%, negative predictive value of 97.0%, and accuracy of 79.9%, which were lower than those of chest CT for accuracy (
< 0.0001). FDG PET/CT could not accurately detect any intrathoracic or distant metastasis. After propensity score matching, the diagnostic accuracy for LN staging of FDG PET/CT in the group who underwent both CT and FDG PET/CT was lower than that of chest CT in the group who did not undergo FDG PET/CT (
= 0.002), and the diagnostic accuracy for intrathoracic and distant metastases was not different (
> 0.999).
FDG PET/CT has limited utility in preoperatively detecting LN or distant metastasis in patients with subsolid NSCLCs with a solid portion size of 3 cm or smaller. |
| doi_str_mv | 10.2214/AJR.19.21811 |
| format | Article |
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We retrospectively enrolled 855 patients with pathologically proven NSCLCs manifesting as subsolid nodules with a solid portion of 3 cm or smaller on CT. We then compared the diagnostic performances of FDG PET/CT and chest CT for detecting lymph node (LN), intrathoracic, or distant metastases in patients who underwent preoperative chest CT and FDG PET/CT. After propensity score matching, we compared the diagnostic performance of FDG PET/CT in the group who underwent both chest CT and FDG PET/CT with that of chest CT in patients who did not undergo FDG PET/CT.
There were LN metastases in 25 of 765 patients (3.3%) who underwent surgical LN dissection or biopsy and intrathoracic or distant metastasis in two of 855 patients (0.2%). For LN staging, FDG PET/CT showed a sensitivity of 44.0%, specificity of 81.5%, positive predictive value of 9.6%, negative predictive value of 97.0%, and accuracy of 79.9%, which were lower than those of chest CT for accuracy (
< 0.0001). FDG PET/CT could not accurately detect any intrathoracic or distant metastasis. After propensity score matching, the diagnostic accuracy for LN staging of FDG PET/CT in the group who underwent both CT and FDG PET/CT was lower than that of chest CT in the group who did not undergo FDG PET/CT (
= 0.002), and the diagnostic accuracy for intrathoracic and distant metastases was not different (
> 0.999).
FDG PET/CT has limited utility in preoperatively detecting LN or distant metastasis in patients with subsolid NSCLCs with a solid portion size of 3 cm or smaller.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.19.21811</identifier><identifier>PMID: 31846374</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Carcinoma, Non-Small-Cell Lung - diagnostic imaging ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Multiple Pulmonary Nodules - diagnostic imaging ; Multiple Pulmonary Nodules - pathology ; Multiple Pulmonary Nodules - surgery ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography ; Preoperative Care ; Propensity Score ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity</subject><ispartof>American journal of roentgenology (1976), 2020-03, Vol.214 (3), p.514-523</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c291t-dfe6dc5b6c498c0286295ce7fcbe7c9065214cdbdfa85037ad51fe432904b8b43</citedby><cites>FETCH-LOGICAL-c291t-dfe6dc5b6c498c0286295ce7fcbe7c9065214cdbdfa85037ad51fe432904b8b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4120,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31846374$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suh, Young Joo</creatorcontrib><creatorcontrib>Park, Chang Min</creatorcontrib><creatorcontrib>Han, Kyunghwa</creatorcontrib><creatorcontrib>Jeon, Sun Kyung</creatorcontrib><creatorcontrib>Kim, Hyungjin</creatorcontrib><creatorcontrib>Hwang, Eui Jin</creatorcontrib><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Paeng, Jin Chul</creatorcontrib><creatorcontrib>Lee, Chang Hoon</creatorcontrib><creatorcontrib>Kim, Young Tae</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><title>Utility of FDG PET/CT for Preoperative Staging of Non-Small Cell Lung Cancers Manifesting as Subsolid Nodules With a Solid Portion of 3 cm or Smaller</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The objective of our study was to investigate the utility of FDG PET/CT for the preoperative staging of subsolid non-small cell lung cancers (NSCLCs) with a solid portion size of 3 cm or smaller.
We retrospectively enrolled 855 patients with pathologically proven NSCLCs manifesting as subsolid nodules with a solid portion of 3 cm or smaller on CT. We then compared the diagnostic performances of FDG PET/CT and chest CT for detecting lymph node (LN), intrathoracic, or distant metastases in patients who underwent preoperative chest CT and FDG PET/CT. After propensity score matching, we compared the diagnostic performance of FDG PET/CT in the group who underwent both chest CT and FDG PET/CT with that of chest CT in patients who did not undergo FDG PET/CT.
There were LN metastases in 25 of 765 patients (3.3%) who underwent surgical LN dissection or biopsy and intrathoracic or distant metastasis in two of 855 patients (0.2%). For LN staging, FDG PET/CT showed a sensitivity of 44.0%, specificity of 81.5%, positive predictive value of 9.6%, negative predictive value of 97.0%, and accuracy of 79.9%, which were lower than those of chest CT for accuracy (
< 0.0001). FDG PET/CT could not accurately detect any intrathoracic or distant metastasis. After propensity score matching, the diagnostic accuracy for LN staging of FDG PET/CT in the group who underwent both CT and FDG PET/CT was lower than that of chest CT in the group who did not undergo FDG PET/CT (
= 0.002), and the diagnostic accuracy for intrathoracic and distant metastases was not different (
> 0.999).
FDG PET/CT has limited utility in preoperatively detecting LN or distant metastasis in patients with subsolid NSCLCs with a solid portion size of 3 cm or smaller.</description><subject>Aged</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnostic imaging</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple Pulmonary Nodules - diagnostic imaging</subject><subject>Multiple Pulmonary Nodules - pathology</subject><subject>Multiple Pulmonary Nodules - surgery</subject><subject>Neoplasm Staging</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Preoperative Care</subject><subject>Propensity Score</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kclOwzAQhi0EgrLcOCMfOZDiLYl9RKFsKlDRIrhFjmODURIXO0HiQXhf3LJcZqTRN_8sPwCHGI0Jwez07OZhjMWYYI7xBhjhlGUJxQxvghGiGU44os87YDeEN4RQzkW-DXYo5iyjORuBr8feNrb_hM7Ai_NLOJssTosFNM7Dmdduqb3s7YeG816-2O5lhd25Lpm3smlgoWOYDrFcyE5pH-Ct7KzRoV-hMsD5UAXX2Dr21EOjA3yy_SuUcL4uzpzvretWmhSqFsaZa13t98GWkU3QB795DzxeTBbFVTK9v7wuzqaJIgL3SW10Vqu0yhQTXCHCMyJSpXOjKp0rgbI0PkjVVW0kTxHNZZ1ioxklArGKV4zugeMf3aV370Pcu2xtUPEq2Wk3hJJQwmmKBacRPflBlXcheG3Kpbet9J8lRuXKiDIaUWJRro2I-NGv8lC1uv6H_z5PvwE3Z4M6</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Suh, Young Joo</creator><creator>Park, Chang Min</creator><creator>Han, Kyunghwa</creator><creator>Jeon, Sun Kyung</creator><creator>Kim, Hyungjin</creator><creator>Hwang, Eui Jin</creator><creator>Lee, Jong Hyuk</creator><creator>Paeng, Jin Chul</creator><creator>Lee, Chang Hoon</creator><creator>Kim, Young Tae</creator><creator>Goo, Jin Mo</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200301</creationdate><title>Utility of FDG PET/CT for Preoperative Staging of Non-Small Cell Lung Cancers Manifesting as Subsolid Nodules With a Solid Portion of 3 cm or Smaller</title><author>Suh, Young Joo ; Park, Chang Min ; Han, Kyunghwa ; Jeon, Sun Kyung ; Kim, Hyungjin ; Hwang, Eui Jin ; Lee, Jong Hyuk ; Paeng, Jin Chul ; Lee, Chang Hoon ; Kim, Young Tae ; Goo, Jin Mo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c291t-dfe6dc5b6c498c0286295ce7fcbe7c9065214cdbdfa85037ad51fe432904b8b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Carcinoma, Non-Small-Cell Lung - diagnostic imaging</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple Pulmonary Nodules - diagnostic imaging</topic><topic>Multiple Pulmonary Nodules - pathology</topic><topic>Multiple Pulmonary Nodules - surgery</topic><topic>Neoplasm Staging</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Preoperative Care</topic><topic>Propensity Score</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suh, Young Joo</creatorcontrib><creatorcontrib>Park, Chang Min</creatorcontrib><creatorcontrib>Han, Kyunghwa</creatorcontrib><creatorcontrib>Jeon, Sun Kyung</creatorcontrib><creatorcontrib>Kim, Hyungjin</creatorcontrib><creatorcontrib>Hwang, Eui Jin</creatorcontrib><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Paeng, Jin Chul</creatorcontrib><creatorcontrib>Lee, Chang Hoon</creatorcontrib><creatorcontrib>Kim, Young Tae</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suh, Young Joo</au><au>Park, Chang Min</au><au>Han, Kyunghwa</au><au>Jeon, Sun Kyung</au><au>Kim, Hyungjin</au><au>Hwang, Eui Jin</au><au>Lee, Jong Hyuk</au><au>Paeng, Jin Chul</au><au>Lee, Chang Hoon</au><au>Kim, Young Tae</au><au>Goo, Jin Mo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of FDG PET/CT for Preoperative Staging of Non-Small Cell Lung Cancers Manifesting as Subsolid Nodules With a Solid Portion of 3 cm or Smaller</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>214</volume><issue>3</issue><spage>514</spage><epage>523</epage><pages>514-523</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><abstract>The objective of our study was to investigate the utility of FDG PET/CT for the preoperative staging of subsolid non-small cell lung cancers (NSCLCs) with a solid portion size of 3 cm or smaller.
We retrospectively enrolled 855 patients with pathologically proven NSCLCs manifesting as subsolid nodules with a solid portion of 3 cm or smaller on CT. We then compared the diagnostic performances of FDG PET/CT and chest CT for detecting lymph node (LN), intrathoracic, or distant metastases in patients who underwent preoperative chest CT and FDG PET/CT. After propensity score matching, we compared the diagnostic performance of FDG PET/CT in the group who underwent both chest CT and FDG PET/CT with that of chest CT in patients who did not undergo FDG PET/CT.
There were LN metastases in 25 of 765 patients (3.3%) who underwent surgical LN dissection or biopsy and intrathoracic or distant metastasis in two of 855 patients (0.2%). For LN staging, FDG PET/CT showed a sensitivity of 44.0%, specificity of 81.5%, positive predictive value of 9.6%, negative predictive value of 97.0%, and accuracy of 79.9%, which were lower than those of chest CT for accuracy (
< 0.0001). FDG PET/CT could not accurately detect any intrathoracic or distant metastasis. After propensity score matching, the diagnostic accuracy for LN staging of FDG PET/CT in the group who underwent both CT and FDG PET/CT was lower than that of chest CT in the group who did not undergo FDG PET/CT (
= 0.002), and the diagnostic accuracy for intrathoracic and distant metastases was not different (
> 0.999).
FDG PET/CT has limited utility in preoperatively detecting LN or distant metastasis in patients with subsolid NSCLCs with a solid portion size of 3 cm or smaller.</abstract><cop>United States</cop><pmid>31846374</pmid><doi>10.2214/AJR.19.21811</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0361-803X |
| ispartof | American journal of roentgenology (1976), 2020-03, Vol.214 (3), p.514-523 |
| issn | 0361-803X 1546-3141 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2328351983 |
| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Carcinoma, Non-Small-Cell Lung - diagnostic imaging Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Female Fluorodeoxyglucose F18 Humans Lung Neoplasms - diagnostic imaging Lung Neoplasms - pathology Lung Neoplasms - surgery Lymphatic Metastasis Male Middle Aged Multiple Pulmonary Nodules - diagnostic imaging Multiple Pulmonary Nodules - pathology Multiple Pulmonary Nodules - surgery Neoplasm Staging Positron Emission Tomography Computed Tomography Preoperative Care Propensity Score Radiopharmaceuticals Retrospective Studies Sensitivity and Specificity |
| title | Utility of FDG PET/CT for Preoperative Staging of Non-Small Cell Lung Cancers Manifesting as Subsolid Nodules With a Solid Portion of 3 cm or Smaller |
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