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首页> 外文期刊>Acta Radiologica >Diagnostic accuracy of 18F-2-deoxy-fluoro-D-glucose positron emission tomography for pN1 lymph nodes in patients with lung cancer.
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Diagnostic accuracy of 18F-2-deoxy-fluoro-D-glucose positron emission tomography for pN1 lymph nodes in patients with lung cancer.

机译：18F-2-脱氧氟-D-葡萄糖正电子发射断层扫描对肺癌患者pN1淋巴结的诊断准确性。

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BACKGROUND: Nodal status has been reported to be one of the most important factors affecting survival in patients with lung cancer. For determining treatment strategy, accurate evaluation of nodal status is expected. PURPOSE: To evaluate the accuracy of (18)F-2-deoxy-fluoro-D-glucose (FDG) positron emission tomography (PET) for diagnosing nodal status in lung cancer patients with pathologically proven N1 (pN1) lymph node metastases, in comparison with that of computed tomography (CT). MATERIAL AND METHODS: Nineteen pN1 patients with primary lung cancer undergoing preoperative CT and FDG-PET were investigated. The diagnosis was confirmed by surgery in all patients. Lymph nodes were considered to be positive when uptake higher than the surrounding mediastinum level was visually observed. Radiological and pathological correlation was investigated, and the association between FDG uptake and the size of metastatic nodes was evaluated. RESULTS: Of the 19 pN1 patients, nodal stage determined by FDG-PET was cN0 in eight, cN1 in four, cN2 in six, and cN3 in one. Thus, FDG-PET provided correct N-staging in 21%, under-staging in 42%, and over-staging in 37%. FDG-PET could not depict pN1 lymph node in six (32%) of 19 patients. In two patients (11%), mild symmetrical hilar and mediastinal accumulation was found and considered as benign physiological uptake. In six patients (32%), the ipsilateral mediastinal uptake was depicted and diagnosed as cN2. One patient was diagnosed as cN3 because of FDG accumulation at the supraclavicular fossa. On CT, nodal staging was cN0 in nine, cN1 in six, and cN2 in four. CT staging was therefore correct in 32%, underestimated in 47%, and overestimated in 21%. CONCLUSION: The diagnostic accuracy of FDG-PET (21%) was low and similar to that of CT (32%); under- and over-diagnosis were found in similar proportions. The limitation of FDG-PET should be recognized when nodal staging might alter the therapeutic strategy in patients with primary lung cancer.
机译：背景：据报道，淋巴结状态是影响肺癌患者生存的最重要因素之一。为了确定治疗策略，期望准确评估淋巴结状态。目的：评估经病理证实的N1（pN1）淋巴结转移的肺癌患者的（18）F-2-脱氧氟-D-葡萄糖（FDG）正电子发射断层扫描（PET）诊断淋巴结状态的准确性，与计算机断层扫描（CT）的比较。材料与方法：对19例原发性肺癌的pN1患者进行了术前CT和FDG-PET检查。所有患者均通过手术证实了诊断。当目测观察到高于周围纵隔水平的摄取时，淋巴结被认为是阳性的。研究了放射学和病理学的相关性，并评估了FDG摄取与转移性淋巴结大小之间的关系。结果：在19例pN1患者中，FDG-PET确定的淋巴结分期为cN0占8个，cN1占4个，cN2占6个，cN3占1个。因此，FDG-PET提供正确的N阶段（21％），不足的阶段（42％）和过度的阶段（37％）。 FDG-PET在19例患者中有6例（32％）无法显示pN1淋巴结。在两名患者（11％）中，发现轻度对称的肺门和纵隔蓄积，被认为是良性的生理摄取。在六名患者（32％）中，同侧纵隔摄取被描绘并诊断为cN2。一名患者由于FDG在锁骨上窝积聚而被诊断为cN3。在CT上，淋巴结分期为9个cN0、6个cN1和4个cN2。因此，CT分期正确的占32％，被低估的占47％，被高估的占21％。结论：FDG-PET的诊断准确性较低（21％），与CT相似（32％）;发现和诊断不足的比例相似。当淋巴结分期可能改变原发性肺癌患者的治疗策略时，应认识到FDG-PET的局限性。

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