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Hyun Joo Lee
Young Tae Kim
Hyun Ju Lee
Chang Hyun Kang
Joo Hyun Kim
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ORIGINAL ARTICLE

Integrated Positron-Emission Tomography for Nodal Staging in Lung Cancer

Hyun Joo Lee, MD, Young Tae Kim, MD, Won Jun Kang, MD, Hyun Ju Lee, MD, Chang Hyun Kang, MD, Joo Hyun Kim, MD

Seoul National University Hospital Seoul, South Korea

Young Tae Kim, MD, Tel: 82 2 2072 3161 Fax: +82 2 765 7117 Email: ytkim{at}snu.ac.kr, Department of Thoracic and Cardiovascular Surgery, Clinical Research Institute, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehangno Jongno-gu, Seoul 110-744, South Korea.

ABSTRACT

As lymph node metastasis is the most important factor determining the surgical outcome of lung cancer, we evaluated the accuracy and clinical usefulness of functional imaging with integrated positron-emission tomography and computed tomography in nodal staging of non-small-cell lung cancer. Between October 2003 and August 2004, 43 newly diagnosed patients underwent curative surgical resection or mediastinoscopic nodal biopsy after chest computed tomography as well as whole-body functional imaging for clinical staging. Based on histopathologic findings in the lymph nodes, we compared the diagnostic usefulness of computed tomography and functional imaging. Twenty-two patients were N0 stage, 6 were N1, 11 were N2, and 4 were N3. Although functional imaging seemed to be superior for evaluation of N2 nodes, there were no significant differences in the sensitivity, specificity, positive-predictive value, negative-predictive value, or accuracy. The situation was similar for N1 nodes, and there were no significant differences except for the false-negative rate. High false-positive and negative-rates for N2 lymph nodes suggest that functional imaging should not replace mediastinoscopy.

Key Words: Lung Neoplasms • Lymph Nodes • Neoplasm Staging • Positron-Emission Tomography • Tomography • X-Ray Computed

Asian Cardiovasc Thorac Ann 2009; 17:622-626
© 2009 by SAGE Publications
DOI: 10.1177/0218492309349253




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