 |
Vol.46 No.2 contents | Japanese/English |
 | Full Text of PDF (612K) Article in Japanese |
- Original Article -
Clinical Usefulness of FDG-PET in the Diagnosis of Lung Cancer
Hidetaka Uramoto1, Kenji Sugio1, Shoji Nakata1, Tetsuya So1, Kenji Ono1, Masakazu Sugaya1, Takeshi Hanagiri1, Minoru Honma2, Kosei Yasumoto11Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Japan, 2Fukuoka Wajiro PET Diagnostic Imaging Clinic, Japan
Objective. The clinical usefulness of FDG-PET in the diagnosis of lung cancer has been well established, however, false positive and negative cases are still sometimes reported. We therefore investigated the clinical usefulness of FDG-PET regarding distinguishing between benign or malignant solitary pulmonary nodules and lymph node metastases. Study Design. The subjects consisted of 37 consecutive cases (27 male, 10 female, mean age 66.7 years) of surgically resected thoracic tumors that had been scanned preoperatively by FDG-PET to define the presence of a benign or malignant, or to determine the clinical staging from March 2004 to July 2005. Primary lung cancers were noted in 33 cases while benign lesions were noted in 4 cases (1 sarcoid reaction, 1 sclerosing hemoinagioma, 1 fibrosis with hyperplasia, and 1 inflammatory lymph node). The operatiove procedures included 1 pneumonectomy, 30 lobectomies, 1 segmentectomy, and 5 partial resections. The pathological types of lung cancer included 18 adenocarcinomas, 9 squamous cell carcinomas, 2 large cell carcinomas, and 4 others. According to the pathological staging, 11 patients were stage IA, 8 stage IB, 3 stage IIB, 4 stage IIIA, 5 stage IIIB, and 2 stage IV. Results. Thirty-two and 5 nodules were positive and negative according to FDG-PET for the primary tumor, respectively. In lung cancers, 31 and 2 cases were positive and negative according to FDG-PET, respectively. In the benign lesions, 1 and 3 cases were positive and negative according to FDG-PET, respectively. The sensitivity and specificity of FDG-PET for detecting the primary tumor lesions were 93.9% and 75.0%, respectively. The 2 adenocarcinomas measuring less than 1 cm in size with a high percentage of ground glass opacity (Noguchi type B) were both false negative. The sensitivity and specificity of FDG-PET for detecting hilar lymph nodes was 100% and 85.2%, respectively. The sensitivity and specificity of FDG-PET for detecting mediastinal lymph nodes was 66.7% and 84.0%, respectively. Conclusion. The FDP-PET detection of main tumor limits for adenocarcinomas measuring less than 1 cm in size with a high percentage of ground glass opacity. On the other hand, there were cases of benign disease that show falsely positive results. We must use FDG-PET for the diagnosis of lung cancer based on a firm grasp of its merits and demerits.
key words: Lung cancer, FDG-PET, False positive, False negative
Received: November 4, 2005
Accepted: January 23, 2006
JJLC 46 (2): 127-131, 2006
