European Journal of Radiology
Volume 45, Issue 1 , Pages 49-59 , January 2003

Value of FDG-PET in the management of non-small cell lung cancer

  • Sigrid Stroobants

      Affiliations

    • Department of Nuclear Medicine, University Hospital Gasthuisberg, Leuven, Belgium
    • Corresponding Author InformationCorresponding author. Present address: UZ Gasthuisberg, Nucleaire Geneeskunde, Herestraat 49, B-3000 Leuven, Belgium. Tel.: +32-16-343714; fax: +32-16-343759
  • ,
  • Johny Verschakelen

      Affiliations

    • Department of Radiology, University Hospital Gasthuisberg, Leuven, Belgium
  • ,
  • Johan Vansteenkiste

      Affiliations

    • Department of Respiratory Oncology, University Hospital Gasthuisberg, Leuven, Belgium

Received 17 September 2002 ,Revised 18 September 2002 ,Accepted 19 September 2002.

References 

  1. Warburg O, Posener K, Negelein E. The metabolism of the carcinoma cell. In:  Warburg O editors. The metabolism of tumors. New York: Richard R. Smith, Inc; 1931;p. 29–169
  2. Pauwels EK, McCready VR, Stoot JH, van Deurzen DF. The mechanism of accumulation of tumour-localising radiopharmaceuticals. Eur. J. Nucl. Med. 1998;25:277–305
  3. Yamada S, Kubota K, Kubota R, Ido T, Tamahashi N. High accumulation of fluorine-18-fluorodeoxyglucose in turpentine-induced inflammatory tissue. J. Nucl. Med. 1995;36:1301–1306
  4. Gurney JW. Determining the likelihood of malignancy in solitary pulmonary nodules with Bayesian analysis. Part I. Theory. Radiology. 1993;186:405–413
  5. Yankelevitz DF, Henschke CI. Does 2-year stability imply that pulmonary nodules are benign?. Am. J. Roentgenol. 1997;168:325–328
  6. Arroliga AC, Matthay RA. The role of bronchoscopy in lung cancer. Clin. Chest Med. 1993;14:87–98
  7. Geddes DM, Elliott M. The solitary pulmonary nodule. Br. Med. J. 1989;298:67–68
  8. Santambrogio L, Nosotti M, Bellaviti N, Pavoni G, Radice F, Caputo V. CT-guided fine-needle aspiration cytology of solitary pulmonary nodules: a prospective, randomized study of immediate cytologic evaluation. Chest. 1997;112:423–425
  9. Larscheid RC, Thorpe PE, Scott WJ. Percutaneous transthoracic needle aspiration biopsy: a comprehensive review of its current role in the diagnosis and treatment of lung tumors. Chest. 1998;114:704–709
  10. Kubota K, Matsuzawa T, Fujiwara T, Ito M, Hatazawa J, Ishiwata K, et al. Differential diagnosis of lung tumor with positron emission tomography: a prospective study. J. Nucl. Med. 1990;31:1927–1932
  11. Gupta NC, Frank AR, Dewan NA, Redepenning LS, Rothberg ML, Mailliard JA, et al. Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro-2-deoxy-d-glucose. Radiology. 1992;184:441–444
  12. Dewan NA, Gupta NC, Redepenning LS, Phalen JJ, Frick MP. Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management. Chest. 1993;104:997–1002
  13. Slosman DO, Spiliopoulos A, Couson F, Nicod L, Louis O, Lemoine R, et al. Satellite PET and lung cancer: a prospective study in surgical patients. Nucl. Med. Commun. 1993;14:955–961
  14. Wahl RL, Quint LE, Greenough RL, Meyer CR, White RI, Orringer MB. Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation. Radiology. 1994;191:371–377
  15. Lowe VJ, Hoffman JM, DeLong DM, Patz EF, Coleman RE. Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities. J. Nucl. Med. 1994;35:1771–1776
  16. Dewan NA, Reeb SD, Gupta NC, Gobar LS, Scott WJ. PET-FDG imaging and transthoracic needle lung aspiration biopsy in evaluation of pulmonary lesions. A comparative risk-benefit analysis. Chest. 1995;108:441–446
  17. Duhaylongsod FG, Lowe VJ, Patz EF, Vaughn AL, Coleman RE, Wolfe WG. Lung tumor growth correlates with glucose metabolism measured by fluoride-18 fluorodeoxyglucose positron emission tomography. Ann. Thorac. Surg. 1995;60:1348–1352
  18. Bury T, Dowlati A, Paulus P, Corhay JL, Benoit T, Kayembe JM, et al. Evaluation of the solitary pulmonary nodule by positron emission tomography imaging. Eur. Respir. J. 1996;9:410–414
  19. Lowe VJ, Fletcher JW, Gobar L, Lawson M, Kirchner P, Valk P, et al. Prospective investigation of positron emission tomography in lung nodules. J. Clin. Oncol. 1998;16:1075–1084
  20. Prauer HW, Weber WA, Romer W, Treumann T, Ziegler SI, Schwaiger M. Controlled prospective study of positron emission tomography using the glucose analogue [18f] fluorodeoxyglucose in the evaluation of pulmonary nodules. Br. J. Surg. 1998;85:1506–1511
  21. Halter G, Storck M, Guhlmann A, Frank J, Grosse S, Liewald F. FDG positron emission tomography in the diagnosis of peripheral pulmonary focal lesions. Thorac. Cardiovasc. Surg. 2000;48:97–101
  22. Imdahl A, Jenkner S, Brink I, Nitzsche E, Stoelben E, Moser E, et al. Validation of FDG positron emission tomography for differentiation of unknown pulmonary lesions. Eur. J. Cardiothorac. Surg. 2001;20:324–329
  23. Croft DR, Trapp J, Kernstine K, Kirchner P, Mullan B, Galvin J, et al. FDG-PET imaging and the diagnosis of non-small cell lung cancer in a region of high histoplasmosis prevalence. Lung Cancer. 2002;36:297–301
  24. Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. J. Am. Med. Assoc. 2001;285:914–924
  25. Erasmus JJ, McAdams HP, Patz EF, Coleman RE, Ahuja V, Goodman PC. Evaluation of primary pulmonary carcinoid tumors using FDG PET. Am. J. Roentgenol. 1998;170:1369–1373
  26. Higashi K, Ueda Y, Seki H, Yuasa K, Oguchi M, Noguchi T, et al. Fluorine-18-FDG PET imaging is negative in bronchioloalveolar lung carcinoma. J. Nucl. Med. 1998;39:1016–1020
  27. Laitinen KL, Soini Y, Mattila J, Paakko P. A typical bronchopulmonary carcinoids show a tendency toward increased apoptotic and proliferative activity. Cancer. 2000;88:1590–1598
  28. Kitamura H, Kameda Y, Nakamura N, Kanegae K, Zhao S, Hikosaka K, et al. Proliferative potential and p53 overexpression in precursor and early stage lesions of bronchioloalveolar lung carcinoma. Am. J. Pathol. 1995;146:876–887
  29. Higashi K, Ueda Y, Sakurai A, Wang XM, Xu L, Murakami M, et al. Correlation of Glut-1 glucose transporter expression with FDG uptake in non-small cell lung cancer. Eur. J. Nucl. Med. 2000;27:1778–1785
  30. Bakheet SM, Saleem M, Powe J, Al-Amro A, Larsson SG, Mahassin Z. F-18 fluorodeoxyglucose chest uptake in lung inflammation and infection. Clin. Nucl. Med. 2000;25:273–278
  31. Kapucu LO, Meltzer CC, Townsend DW, Keenan RJ, Luketich JD. Fluorine-18-fluorodeoxyglucose uptake in pneumonia. J. Nucl. Med. 1998;39:1267–1269
  32. Franzius C, Biermann M, Hulskamp G, Frosch M, Roth J, Sciuk J, et al. Therapy monitoring in aspergillosis using F-18 FDG positron emission tomography. Clin. Nucl. Med. 2001;26:232–233
  33. Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology. 2000;216:117–121
  34. Brudin LH, Valind SO, Rhodes CG, Pantin CF, Sweatman M, Jones T, et al. Fluorine-18 deoxyglucose uptake in sarcoidosis measured with positron emission tomography. Eur. J. Nucl. Med. 1994;21:297–305
  35. Mochizuki T, Tsukamoto E, Kuge Y, Kanegae K, Zhao S, Hikosaka K, et al. FDG uptake and glucose transporter subtype expressions in experimental tumor and inflammation models. J. Nucl. Med. 2001;42:1551–1555
  36. Vansteenkiste J, De Leyn P, Deneffe G, Menten J, Lerut T, Demedts M. Present status of induction treatment for N2 non-small cell lung cancer: a review. Eur. J. Cardiothorac. Surg. 1998;13:1–12
  37. Martini N, Kris MG, Ginsberg RJ. The role of multimodality therapy in locoregional non-small cell lung cancer. Surg. Oncol. Clin. N. Am. 1997;6:769–791
  38. Webb WR, Gatsouris S, Zerhouni EA, Heelan RT, Glazer GM, Francis IR, et al. CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiology Diagnostic Oncology Group. Radiology. 1991;178:705–713
  39. Dillemans B, Deneffe G, Verschakelen J, Decramer M. Value of computed tomography and mediastinoscopy in preoperative evaluation of mediastinal nodes in non-small cell lung cancer. Eur. J. Cardiothorac. Surg. 1994;8:37–42
  40. Saunders CA, Dussek JE, O'Doherty MJ, Maisey MN. Evaluation of fluorine-18-fluorodeoxyglucose whole body positron emission tomography imaging in the staging of lung cancer. Ann. Thorac. Surg. 1999;67:790–797
  41. Valk PE, Pounds TR, Hopkins DM, Haseman MK, Hofer GA, Greiss HB, et al. Staging non-small cell lung cancer by whole-body positron emission tomographic imaging. Ann. Thorac. Surg. 1995;60:1573–1581
  42. Vansteenkiste JF, Stroobants SG, De Leyn PR, Dupont PJ, Bogaert J, Maes A, et al. Lymph node staging in non-small-cell lung cancer with FDG-PET scan: a prospective study on 690 lymph node stations from 68 patients. J. Clin. Oncol. 1998;16:2142–2149
  43. Kernstine KH, Mclaughlin KA, Menda Y, Rossi NP, Kahn DJ, Bushnell DL, et al. Can FDG-PET reduce the need for mediastinoscopy in potentially respectable non-small cell lung cancer?. Ann. Thorac. Surg. 2002;73:394–401
  44. Vansteenkiste JF, Stroobants SG, Dupont PJ, De Leyn PR, De Wever WF, Verbeken EK, et al. FDG-PET scan in potentially operable non-small cell lung cancer: do anatometabolic PET–CT fusion images improve the localisation of regional lymph node metastases? The Leuven Lung Cancer Group. Eur. J. Nucl. Med. 1998;25:1495–1501
  45. Vansteenkiste JF, Stroobants SG, De Leyn PR, Dupont PJ, Verschakelen JA, Nackaerts KL, et al. Mediastinal lymph node staging with FDG-PET scan in patients with potentially operable non-small cell lung cancer: a prospective analysis of 50 cases Leuven Lung Cancer Group. Chest. 1997;112:1480–1486
  46. Bury T, Paulus P, Dowlati A, Corhay JL, Weber T, Ghaye B, et al. Staging of the mediastinum: value of positron emission tomography imaging in non-small cell lung cancer. Eur. Respir. J. 1996;9:2560–2564
  47. Weng E, Tran L, Rege S, Safa A, Sadeghi A, Juillard G, et al. Accuracy and clinical impact of mediastinal lymph node staging with FDG-PET imaging in potentially resectable lung cancer. Am. J. Clin. Oncol. 2000;23:47–52
  48. Berlangieri SU, Scott AM, Knight SR, Fitt GJ, Hennessy OF, Tochon-Danguy HJ, et al. F-18 fluorodeoxyglucose positron emission tomography in the non-invasive staging of non-small cell lung cancer. Eur. J. Cardiothorac. Surg. 1999;16(Suppl 1):S25–S30
  49. Patz EF, Lowe VJ, Goodman PC, Herndon J. Thoracic nodal staging with PET imaging with 18FDG in patients with bronchogenic carcinoma. Chest. 1995;108:1617–1621
  50. Chin R, Ward R, Keyes JW, Choplin RH, Reed JC, Wallenhaupt S, et al. Mediastinal staging of non-small-cell lung cancer with positron emission tomography. Am. J. Respir. Crit. Care Med. 1995;152:2090–2096
  51. Scott WJ, Gobar LS, Hauser LG, Sunderland JJ, Dewan NA, Sugimoto JT. Detection of scalene lymph node metastases from lung cancer. Positron emission tomography. Chest. 1995;107:1174–1176
  52. Sazon DA, Santiago SM, Soo Hoo GW, Khonsary A, Brown C, Mandelkern M, et al. Fluorodeoxyglucose-positron emission tomography in the detection and staging of lung cancer. Am. J. Respir. Crit. Care Med. 1996;153:417–421
  53. Steinert HC, Hauser M, Allemann F, Engel H, Berthold T, von Schulthess GK, et al. Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling. Radiology. 1997;202:441–446
  54. Sasaki M, Ichiya Y, Kuwabara Y, Akashi Y, Yoshida T, Fukumura T, et al. The usefulness of FDG positron emission tomography for the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer: a comparative study with X-ray computed tomography. Eur. J. Nucl. Med. 1996;23:741–747
  55. Dwamena BA, Sonnad SS, Angobaldo JO, Wahl RL. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s—meta-analytic comparison of PET and CT. Radiology. 1999;213:530–536
  56. Hellwig D, Ukena D, Paulsen F, Bamberg M, Kirsch CM. Meta-analysis of the efficacy of positron emission tomography with F-18-fluorodeoxyglucose in lung tumors. Basis for discussion of the German Consensus Conference on PET in Oncology 2000. Pneumologie. 2001;55:367–377
  57. Vansteenkiste JF, Stroobants SG. The role of positron emission tomography with 18F-fluoro-2-deoxy-d-glucose in respiratory oncology. Eur. Respir. J. 2001;17:802–820
  58. Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics 1997. CA Cancer J. Clin. 1997;47:5–27
  59. Quint LE, Tummala S, Brisson LJ, et al.  Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann. Thorac. Surg. 1996;62:246–250
  60. Pantel K, Izbicki J, Passlick B, Angstwurm M, Haussinger K, Thetter O, et al. Frequency and prognostic significance of isolated tumour cells in bone marrow of patients with non-small-cell lung cancer without overt metastases. Lancet. 1996;347:649–653
  61. Bury T, Barreto A, Daenen F, et al.  Fluorine-18 deoxyglucose positron emission tomography for the detection of bone metastases in patients with non-small cell lung cancer. Eur. J. Nucl. Med. 1998;25:1244–1247
  62. Marom EM, McAdams HP, Erasmus JJ, Goodman PC, Culhane DK, Coleman RE, et al. Staging non-small cell lung cancer with whole-body PET. Radiology. 1999;212:803–809
  63. Oliver TW, Bernardino ME, Miller JI, Mansour K, Greene D, Davis WA. Radiology Isolated adrenal masses in nonsmall-cell bronchogenic carcinoma. Radiology. 1984;153:217–218
  64. Nielsen ME, Heaston DK, Dunnick NR, Korobkin M. Preoperative CT evaluation of adrenal glands in non-small cell bronchogenic carcinoma. Am. J. Roentgenol. 1982;139:317–320
  65. Pagani JJ. Non-small cell lung carcinoma adrenal metastases. Computed tomography and percutaneous needle biopsy in their diagnosis. Cancer. 1984;53:1058–1060
  66. Ettinghausen SE, Burt ME. Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer. J. Clin. Oncol. 1991;9:1462–1466
  67. Erasmus JJ, Patz EF, McAdams HP, Murray JG, Herndon J, Coleman RE, et al. Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography. Am. J. Roentgenol. 1997;168:1357–1360
  68. Boland GW, Goldberg MA, Lee MJ, Mayo-Smith WW, Dixon J, McNicholas MM, et al. Indeterminate adrenal mass in patients with cancer: evaluation at PET with 2-[F-18]-fluoro-2-deoxy-d-glucose. Radiology. 1995;194:131–134
  69. Yun M, Kim W, Alnafisi N, Lacorte L, Jang S, Alavi A. 18F-FDG PET in characterizing adrenal lesions detected on CT or MRI. J. Nucl. Med. 2001;42:1795–1799
  70. Patz EF, Erasmus JJ, McAdams HP, Connolly JE, Marom EM, Goodman PC, et al. Lung cancer staging and management: comparison of contrast-enhanced and nonenhanced helical CT of the thorax. Radiology. 1999;212:56–60
  71. Hustinx R, Paulus P, Jacquet N, Jerusalem G, Bury T, Rigo P. Clinical evaluation of whole-body 18F-fluorodeoxyglucose positron emission tomography in the detection of liver metastases. Ann. Oncol. 1998;9:397–401
  72. Griffeth LK, Rich KM, Dehdashti F, Simpson JR, Fusselman MJ, McGuire AH, et al. Brain metastases from non-central nervous system tumors: evaluation with PET. Radiology. 1993;186:37–44
  73. Weder W, Schmid RA, Bruchhaus H, Hillinger S, von Schulthess GK, Steinert HC. Detection of extrathoracic metastases by positron emission tomography in lung cancer. Ann. Thorac. Surg. 1998;66:886–892
  74. Pieterman RM, van Putten JW, Meuzelaar JJ, Mooyaart EL, Vaalburg W, Koeter GH, et al. Preoperative staging of non-small-cell lung cancer with positron-emission topography. N. Engl. J. Med. 2000;343:254–261
  75. Bury T, Dowlati A, Paulus P, Corhay JL, Hustinx R, Ghaye B, et al. Whole-body 18FDG positron emission tomography in the staging of non-small cell lung cancer. Eur. Respir. J. 1997;10:2529–2534
  76. van Tinteren H, Hoekstra OS, Smit EF, van den Bergh JH, Schreurs AJ, Stallaert RA, et al. Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet. 2002;359:1388–1393
  77. MacManus MP, Hicks RJ, Matthews JP, Hogg A, McKenzie AF, Wirth A, et al. High rate of detection of unsuspected distant metastases by pet in apparent stage III non-small-cell lung cancer: implications for radical radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 2001;50:287–293
  78. Kalff V, Hicks RJ, MacManus MP, Binns DS, McKenzie AF, Ware RE, et al. Clinical impact of (18)F fluorodeoxyglucose positron emission tomography in patients with non-small-cell lung cancer: a prospective study. J. Clin. Oncol. 2001;19:111–118
  79. WHO handbook for reporting results of cancer treatment. Geneva (Switzerland): World Organisation of Health Offset Publication No 48, 1979.
  80. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. J. Natl. Cancer Inst. 2000;92:205–216
  81. Minn H, Joensuu H, Ahonen A, Klemi P. Fluorodeoxyglucose imaging: a method to assess the proliferative activity of human cancer in vivo. Comparison with DNA flow cytometry in head and neck tumors. Cancer. 1988;61:1776–1781
  82. Higashi K, Clavo AL, Wahl RL. Does FDG uptake measure proliferative activity of human cancer cells? In vitro comparison with DNA flow cytometry and tritiated thymidine uptake. J. Nucl. Med. 1993;34:414–419
  83. Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R. Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J. Clin. Oncol. 1993;11:2101–2111
  84. Schelling M, Avril N, Nahrig J, Kuhn W, Romer W, Sattler D, et al. Positron emission tomography using Fluorodeoxyglucose for monitoring primary chemotherapy in breast cancer. J. Clin. Oncol. 2000;18:1689–1695
  85. Smith IC, Welch AE, Hutcheon AW, Miller ID, Payne S, Chilcott F, et al. Positron emission tomography using [(18)F]-fluorodeoxy-d-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J. Clin. Oncol. 2000;18:1676–1688
  86. Romer W, Hanauske AR, Ziegler S, Thodtmann R, Weber W, Fuchs C, et al. Positron emission tomography in non-Hodgkin's lymphoma: assessment of chemotherapy with fluorodeoxyglucose. Blood. 1998;91:4464–4471
  87. Brucher BL, Weber W, Bauer M, Fink U, Avril N, Stein HJ, et al. Neoadjuvant therapy of esophageal squamous cell carcinoma: response evaluation by positron emission tomography. Ann. Surg. 2001;233:300–309
  88. van Oosterom AT, Judson I, Verweij J, Stroobants S, Donato di Paola E, Dimitrijevic S, et al. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet. 2001;358:1421–1423
  89. Vansteenkiste JF, Stroobants SG, De Leyn PR, Dupont PJ, Verbeken EK. Potential use of FDG-PET scan after induction chemotherapy in surgically staged IIIa-N2 non-small-cell lung cancer: a prospective pilot study. The Leuven Lung Cancer Group. Ann. Oncol. 1998;9:1193–1198
  90. Akhurst T, Downey RJ, Ginsberg MS, Gonen M, Bains M, Korst R, et al. An initial experience with FDG-PET in the imaging of residual disease after induction therapy for lung cancer. Ann. Thorac. Surg. 2002;73:259–264
  91. Ryu JS, Choi NC, Fischman AJ, Lynch TJ, Mathisen DJ. FDG-PET in staging and restaging non-small cell lung cancer after neoadjuvant chemoradiotherapy: correlation with histopathology. Lung Cancer. 2002;35:179–187
  92. Kumar P, Herndon J, Langer M, Kohman LJ, Elias AD, Kass FC, et al. Patterns of disease failure after trimodality treatment for non-small cell lung carcinoma pathologic stage IIIA(N2). Cancer. 1996;77:2393–2399
  93. Vansteenkiste J, De Leyn P, Deneffe G, Menten J, Lerut T, Demedts M. Present status of induction treatment for N2 non-small cell lung cancer: a review. Eur. J. Cardiothorac. Surg. 1998;13:1–12
  94. Martini N, Kris MG, Ginsberg RJ. The role of multimodality therapy in locoregional non-small cell lung cancer. Surg. Oncol. Clin. N. Am. 1997;6:769–791
  95. Pisters KM, Kris MG, Gralla RJ, Zaman MB, Heelan RT, Martini N. Pathologic complete response in advanced non-small-cell lung cancer following preoperative chemotherapy: implications for the design of future non-small-cell lung cancer combined modality trials. J. Clin. Oncol. 1993;11:1757–1762
  96. Bueno R, Richards WG, Swanson SJ, Jaklitsch MT, Lukanich JM, Mentzer SJ, et al. Nodal stage after induction therapy for stage IIIA lung cancer determines patient survival. Ann. Thorac. Surg. 2000;70:1826–1831
  97. Choi NC, Carey RW, Daly W, Mathisen D, Wain J, Wright C, et al. Potential impact on survival of improved tumor downstaging and resection rate by preoperative twice-daily radiation and concurrent chemotherapy in stage IIIA non-small-cell lung cancer. J. Clin. Oncol. 1997;15:712–722
  98. Voltolini L, Luzzi L, Ghiribelli C, Paladini P, Di Bisceglie M, Gotti G. Results of induction chemotherapy followed by surgical resection in patients with stage IIIA (N2) non-small cell lung cancer: the importance of the nodal down-staging after chemotherapy. Eur. J. Cardiothorac. Surg. 2001;20:1106–1112
  99. Pauwels M, Van Schil P, De Backer W, Van den Brande F, Eyskens E. Repeat mediastinoscopy in the staging of lung cancer. Eur. J. Cardiothorac. Surg. 1998;14:271–273
  100. Van steenkiste J, Stroobants S, Hoekstra C, Smit E, van Zandwijk N, Schramel F, et al. 18 fluorodeoxyglucose positron emission tomography (PET) in the assessment of induction chemotherapy in stage IIIA-N2 NSCLC: a multi-centre prospective study. Proc. Am. Soc. Clin. Oncol. 2001;20:313A; (abstract)

PII: S0720-048X(02)00282-6

European Journal of Radiology
Volume 45, Issue 1 , Pages 49-59 , January 2003