Accuracy of positron emission tomography in mediastinal node assessment in coal workers with lung cancer |
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Authors: | Ozkan Saydam Mertol Gokce Ali Kilicgun Ozgur Tanriverdi |
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Institution: | (1) Department of Thoracic Surgery, Karaelmas University Faculty of Medicine, Zonguldak, Turkey;(2) Department of Thoracic Surgery, Izzet Baysal University Faculty of Medicine, Bolu, Turkey;(3) Department of Medical Oncology, Adnan Menderes University Faculty of Medicine, Aydin, Turkey; |
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Abstract: | The purpose of this study was to explore the accuracy of 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in the assessment of mediastinal lymph
node in coal workers who had non-small cell lung cancer. We retrospectively reviewed 42 retired coal workers who had lung
cancer without distant metastasis, between May 2007 and May 2010. Regarding the mediastinal lymph nodes, when the standard
uptake value was greater than 2.5, it was considered “malignancy positive.” After histological examination of the mediastinal
lymph nodes, anthracotic and metastatic ones were detected. The results of PET/CT were analyzed to determine its accuracy.
Of these 42 patients, PET/CT detected 47 positive mediastinal lymph nodes in 24 patients with a mean SUV maximum of 6.2 (2.6–13.8).
One hundred and thirty-one mediastinal lymph node foci were dissected. The sensitivity, specificity, positive predictive value,
negative predictive value, and accuracy of FDG-PET/CT in detecting nodal metastases were 84% (16/19), 65% (15/23), 66% (16/24),
83% (15/18), and 74% (31/42) on a per-patient basis, respectively. Mediastinal node staging with FDG-PET/CT in coal workers
is insufficient due to the high false-positive rates due to the presence of pneumoconiosis. In these patients, an invasive
technique such as mediastinoscopy seems mandatory for confirmation of ipsilateral or contralateral mediastinal lymph node
metastasis. |
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