Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

Kasai, Takami; Motoori, Ken; Horikoshi, Takuro; Uchiyama, Katsuhiro; Yasufuku, Kazuhiro; Takiguchi, Yuichi; Takahashi, Fumiaki; Kuniyasu, Yoshio; Ito, Hisao

doi:10.1016/j.ejrad.2009.04.044

« Previous Next »European Journal of Radiology
Volume 75, Issue 2 , Pages 143-146, August 2010

Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

Takami Kasai
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677, Japan
- Corresponding author. Tel.: +81 43 222 7171; fax: +81 43 226 2101.
Ken Motoori
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677, Japan
- Tel.: +81 43 222 7171; fax: +81 43 226 2101.
Takuro Horikoshi
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677, Japan
- Tel.: +81 43 222 7171; fax: +81 43 226 2101.
Katsuhiro Uchiyama
- Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002, Japan
- Tel.: +81 43 421 5660; fax: +81 43 421 6581.
Kazuhiro Yasufuku
- Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670, Japan
- Tel.: +81 43 222 7171; fax: +81 43 226 2172.
Yuichi Takiguchi
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670, Japan
- Tel.: +81 43 222 7171; fax: +81 43 226 2176.
Fumiaki Takahashi
- Division of Biostatistics, Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
- Tel.: +81 3 5791 6322; fax: +81 3 3444 2546.
Yoshio Kuniyasu
- Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002, Japan
- Tel.: +81 43 421 5660; fax: +81 43 421 6581.
Hisao Ito
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677, Japan
- Tel.: +81 43 222 7171; fax: +81 43 226 2101.

Received 28 October 2008; accepted 14 April 2009.

Abstract

Purpose

To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT.

Materials and methods

PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1h, and on delayed scans (SUVd) 2h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p<0.05 was considered statistically significant.

Results

Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation.