Japanese Journal of Clinical Oncology Advance Access originally published online on October 26, 2006
Japanese Journal of Clinical Oncology 2006 36(11):694-698; doi:10.1093/jjco/hyl092
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 Foundation for Promotion of Cancer Research
Characteristics of Advantages of Positron Emission Tomography over Computed Tomography for N-staging in Lung Cancer Patients
1 Department of Internal Medicine, Saiseikai Central Hospital, Tokyo
2 Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo
3 Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto,
4 Nishidai Clinic, Tokyo
5 Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
For reprints and all correspondence: Hiroaki Nomori, Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan. E-mail: hnomori{at}kaiju.medic.kumamoto-u.ac.jp
Received March 2, 2006; accepted July 16, 2006
OBJECTIVE: We analyzed the characteristics of advantages of positron emission tomography (PET) over computed tomography (CT) for N-staging in lung cancer patients.
METHODS: Preoperative PET and CT scans were performed for 2057 lymph node stations in 205 patients with peripheral-type lung cancer. The advantages of PET over CT for N-staging were analyzed among lymph node locations and histological subtypes.
RESULTS: The pathological N-stages were N0 in 143 patients, N1 in 31, N2 in 24 and N3 in 7. PET was able to diagnose N0, N2 and N3 diseases more accurately than CT (P=0.03, 0.01 and 0.02, respectively), but there was no significant difference between the two modalities for N1 disease. In the upper mediastinal lymph node stations, both false-negative and false-positive were significantly less frequent with PET than with CT (P=0.001). In the lower mediastinal and supra clavicle lymph nodes, PET showed a lower frequency of false-negative than CT (P=0.04 and 0.003, respectively), but there was no significant difference in the frequency of false-positive between the two modalities. Among histological types, PET could stage adenocarcinoma with less frequent false-negative and squamous cell carcinoma with less frequent false-positive than CT (P=0.02 and 0.005, respectively).
CONCLUSION: For N-staging, PET was superior to CT for the following: (1) more accurate for N0, N2 and N3 diseases but not for N1; (2) lower frequency of false-positive in the upper mediastinal nodes; and (3) lower frequencies of false-negative in adenocarcinoma and false-positive in squamous cell carcinoma. Recognizing these advantages of PET could make the N-staging of lung cancer more accurate.
Key Words: positron emission tomography • computed tomography • lymph node stage • lung cancer • adenocarcinoma
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H. Nomori, T. Mori, K. Ikeda, K. Kawanaka, S. Shiraishi, K. Katahira, and Y. Yamashita Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of non-small cell lung cancer with fewer false-positive results. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 816 - 822. [Abstract] [Full Text] [PDF]
|
|