JOURNAL ARTICLE

Diagnostic accuracy of virtual 18F-FDG PET/CT bronchoscopy for the detection of lymph node metastases in non-small cell lung cancer patients

Michael Herbrik, Jon Treffert, Bernhard Geiger, Carolin Riegger, Verena Hartung, Sandra Julia Rosenbaum-Krumme, Michael Forsting, Gerald Antoch, Till A Heusner
Journal of Nuclear Medicine 2011, 52 (10): 1520-5
21908390

UNLABELLED: The aim of this study was to determine the diagnostic accuracy of (18)F-FDG PET/CT bronchoscopy for the detection of regional lymph node metastases in non-small cell lung cancer (NSCLC) patients; potential differences in the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), short-axis diameter, and distance to the airways when comparing true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) lymph nodes; the smallest bronchus diameter accessible by virtual bronchoscopy; and the duration from the start of the virtual (18)F-FDG PET/CT bronchoscopy viewing tool until the images were displayed.

METHODS: Sixty-one consecutive NSCLC patients (mean age ± SD, 58 ± 10 y) underwent whole-body (18)F-FDG PET/CT. From these data, virtual (18)F-FDG PET/CT bronchoscopies were reconstructed. The duration from the start of the tool until the display of virtual bronchoscopy images was determined. The diagnostic accuracy of (18)F-FDG PET/CT bronchoscopy for the detection of regional lymph node metastases was evaluated on a lesion basis. Axial (18)F-FDG PET/CT scans served as the standard of reference. The SUVmax, SUVmean, short-axis diameter, and distance to the airways of regional lymph nodes were measured. Lymph nodes were classified as TP, FP, TN, and FN. The smallest bronchus diameter accessible by (18)F-FDG PET/CT bronchoscopy was measured.

RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of virtual (18)F-FDG PET/CT bronchoscopy for the detection of lymph node metastases were 76%, 87%, 85%, 79%, and 81%, respectively. The differences between the SUVmax, SUVmean, short-axis diameter, and distance to the airways of TP and FP as well as TN and FN lymph nodes were statistically significant (P < 0.05). The mean smallest diameter of accessible bronchi by (18)F-FDG PET/CT bronchoscopy was 3 mm. The mean time duration from the start of the virtual (18)F-FDG PET/CT bronchoscopy tool until the display of the images was 22 ± 7 s.

CONCLUSION: Virtual fly-through 3-dimensional (18)F-FDG PET/CT bronchoscopy yields a high diagnostic accuracy for the detection of regional lymph node metastases and has access to bronchi even in the periphery of the lung. High SUVmax, high SUVmean, large small-axis diameter, and short distance to the airways aid detection of lymph node metastases with (18)F-FDG PET/CT bronchoscopy.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
21908390
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"