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DOI: 10.1055/s-2000-9870
How Useful is Positron Emission Tomography for Lymphnode Staging in Non-Small-Cell Lung Cancer?
Publikationsverlauf
October 24, 1999
Publikationsdatum:
31. Dezember 2000 (online)
![](https://www.thieme-connect.de/media/thoracic/200002/lookinside/thumbnails/10.1055-s-2000-9870-1.jpg)
The introduction of positron emission tomography (PET) raises the question of the new method's capabilities in the staging of mediastinal lymphnodes, since PET differentiates between metabolically active and inactive tissues. 80 patients with histologically confirmed non-small-cell lung cancer (NSCLC) underwent PET scanning with 18-F-marked fluorodeoxyglucose (FDG). Extensive dissection of mediastinal lymphnodes (18 - 28 lymphnodes recovered) was performed in 78 cases. Metastasis to mediastinal lymphnodes were observed in 25 patients (N2: 22 ; N3: 3). Results: Primary Tumor: FDG-PET showed significant enhancement of the primary tumor in 78 of 80 patients (sensitivity: 97 %). Lymphnode Involvement: FDG-PET was positive in 23 of 25 patients with surgically confirmed lymphnode involvement (sensitivity: 92 %). After a median follow up intervall of 18 months, 11 patients with false positive lymphnode uptake were still alive; 10 of them showed no tumor recurrency. On the basis of these findings, enlarged mediastinal lymphnodes visualized at CT, but negative at FDG-PET are free of metastatic involvement with a sensitivity of 92 %. FDG uptake of mediastinal lymphnodes at PET, however, should not be interpreted as proof of malignancy.
Key words:
Positron emission tomography - Non-small-cell lung cancer - Fluoride-18 marked fluorodeoxyglucose - FDG-PET
References
- 1 McLoud T C, Bourgoin P M, Greenberg R W, Kosiuk J P, Templeton P A, Shepard J AO. et al . Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. Radiology.. 1992; 182 319-23
- 2 White P G, Adams H, Crane M D, Butchard E G. Preoperative staging of carcinoma of the bronchus: can computed tomographic scanning reliably identify stage III tumours?. Thorax.. 1994; 49 951-7
- 3 Kerr K M, Lamb D, Wathen C G, Walker W S, Douglas N J. Pathological assessment of mediastinal lymph nodes in lung cancer: implications for non-invasive mediastinal staging. Thorax.. 1992; 47 337-41
- 4 Arita T, Kuramitsu T, Kawamura M, Matsumoto T, Matsunaga N, Sugi K. et al . Bronchogenic carcinoma: incidence of metastases to normal sized lymph nodes. Thorax.. 1995; 50 1267-9
- 5 Webb W R, Gatsonis C, Zerhouni E A, Glazer G M, Francis I R. et al . CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiologic Diagnostic Oncology Group. Radiology.. 1991; 178 705-13
- 6 Warburg O. The metabolism of tumors. New York; Richard R Smith 1931 1st ed.: 129-69
- 7 Som P, Stkins H L, Bandophadhyah D, Fowler J S, MacGregor R R, Matsui K. et al . A fluorinated glucose analog, 2-fluoro-2-deoxy-D-glucose (F-18): non-toxic tratet for rapid tumor detection. J Nucl Med.. 1980; 21 670-5
- 8 Reske S N, Bares R, Büll U, Guhlmann A, Moser E, Wannenmacher M F. Klinische Wertigkeit der Positronen-Emissions-Tomographie (PET) bei onkologischen Fragestellungen: Ergebnisse einer interdisziplinären Konsensuskonferenz. Nuklearmedizin.. 1996; 35 42-52
- 9 Albes J M, Lietzenmayer R, Schott U, Schülen E, Wehrmann M, Ziemer G. Improvement of Non-Small-Cell lung Cancer Staging by Means of Positron Emission Tomography. Thorac Cardiovasc Surg.. 1999; 47 42-7
- 10 Hermanek P, Sobin L H. TNM classification of malignant tumours. Berlin; Springer-Verlag 1997 5. Auflage
- 11 Naruke T, Suemasu K, Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg.. 1978; 76 832-9
- 12 Bateson E M. An analysis of 155 solitary lung lesions illustrating the differential diagnosis of mixed tumors of the lung. Clin Radiol.. 1965; 16 51-65
- 13 Bury T, Dowlati A, Paulus P, Corhay J L, Benoit T, Kayembe J M, Limet R, Rigo P, Rademecker M. Evaluation of the solitary pulmonary nodule by positron emission tomography imaging. Eur Respir J. 1996: 410-4
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