Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 85  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 16  |  Issue : 4  |  Page : 281-285

The role of fluorodeoxy-D-glucose positron emission tomography/computed tomography in nodal staging of nonsmall cell lung cancer in sequential surgical algorithm


1 Department of Radiology, Augusta University, Augusta, GA 30912, USA
2 Department of Statistics, Augusta University, Augusta, GA 30912, USA
3 Department of Thoracic Surgery, Augusta University, Augusta, GA 30912, USA

Correspondence Address:
Vijay Patel
Department of Thoracic Surgery, 1459 Laney Walker Blvd., Augusta, GA 30912
USA
Login to access the Email id


DOI: 10.4103/1450-1147.215486

PMID: 29033676

Rights and Permissions

With nonsmall cell lung cancer (NSCLC), accurate mediastinal nodal staging is crucial to determine whether a patient is or is not a surgical candidate. Traditionally, computed tomography (CT) and fluorodeoxy-D-glucose (FDG) positron emission tomography (PET)/CT are the initial steps followed by tissue sampling through mediastinoscopy and/or thoracotomy, which are invasive procedures. There is controversy regarding the possibility of omission of the invasive diagnostic procedures and solely relying on noninvasive presurgical staging CT and FDG PET/CT results. Eighty-three patients who had PET/CT, mediastinoscopy, and thoracotomy for NSCLC were analyzed. For all lymph nodes that may be sampled by mediastinoscopy, PET/CT sensitivity was 80%, specificity was 86%, positive predictive value was 47%, and negative predictive value (NPV) was 97%; and for those in this group whose clinical stage was T1/T2 M0, sensitivity was 100% and specificity was 84%. For lymph nodes accessible only at thoracotomy, sensitivity was 42% and specificity was 88%. FDG PET/CT is accurate in assessing stations 2R/L, 4R/L, and 7 nodes and has the potential to replace mediastinoscopy in the treatment algorithm of T1/T2 M0 disease. A negative PET/CT may potentially prevent the patient from invasive mediastinoscopy given its high NPV. However, a patient with positive PET/CT should undergo tissue biopsy with pathology confirmation.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1558    
    Printed51    
    Emailed0    
    PDF Downloaded204    
    Comments [Add]    
    Cited by others 1    

Recommend this journal