| The role of the PET-CT in staging of lung cancer |
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Sung Ho Ki, Seung Hee Lee, In Young Hyun, Kyung Hee Lee, Jae Hwa Cho, Jeong Seon Ryu, Hong Lyeol Lee, Seung Min Kwak |
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고려대학교 의과대학 내과학교실 |
| 원저:폐암 병기 결정에서 PET-CT의 역할에 대한 연구 |
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기성호, Seung Hee Lee, In Young Hyun, Kyung Hee Lee, Jae Hwa Cho, Jeong Seon Ryu, Hong Lyeol Lee, Seung Min Kwak |
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| Abstract |
Background : PET-CT can provide both a physiological and anatomical image with the
benefits of both PET and CT scanners. This may improve the accuracy of a diagnosis of a
mediastinal lymph node metastasis. The aims of this study were to compare PET-CT versus CT
on the nodal staging of lung cancer and to determine if it could be used to avoid an invasive
diagnostic examination. The benefit of the additional PET-CT as preoperative evaluation of the
lung cancer was also assessed.
Methods
: The results of CT and PET-CT scanning in 22 patients with a proven non-small
cell lung cancer (NSCLC) were correlated with the pathological findings of lymph node sampling
using mediastinoscopy or surgery.
Results
: The sensitivity, specificity, accuracy, positive and negative predictive values of CT
for detecting metastatic lymphadenopathy were 44%, 77%, 64%, 57%, and 67%, respectively. For
PET-CT, these were 78%, 92%, 86%, 88%, and 86%, respectively. The earlier detection of a bone
metastasis was obtained by PET-CT in 3 cases, which was not detected in bone scan.
Conclusions
: Better results for nodal staging and higher negative-predictive values by
PET-CT (than CT) can avoid the need for invasive mediastinal staging of the lung cancer with
negative mediastinal lymph node metastasis. An additional histological evaluation by
mediastinoscopy needs to be done when positive findings are detected by PET-CT. PET-CT is
also helpful in detecting a distant metastasis and avoiding unnecessary surgery. More accurate
diagnostic staging can be expected using the simultaneous execution of PET-CT with a
conventional preoperative evaluation of lung cancer.(Korean J Med 71:627-634, 2006)
Key Wards : Lung Cancer, Cancer Staging, Computed Tomography, PET-CT |
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