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Vol.54 No.4 contents | Japanese/English |
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- Original Article -
Image Diagnosis of N1 Lymph Node Metastasis in Non-small Cell Lung Cancer
Tatsuo Nakagawa1,2, Norihito Okumura1, Tomoaki Matsuoka1, Kotaro Kameyama11Department of Thoracic Surgery, Kurashiki Central Hospital, Japan, 2Department of Thoracic Surgery, Tenri Hospital, Japan
Objective. We assessed the preciseness of preoperative diagnosis for N1 metastasis of non-small cell lung cancer (NSCLC) using conventional CT and PET/CT. Methods. A total of 109 patients with NSCLC who underwent lobectomy with node dissection was included in the study. Diameter of short axis and maximum standardized uptake value (SUVmax) of dissected N1 lymph nodes were retrospectively measured. Results. A total of 306 lymph nodes were pathologically and graphically evaluated. In CT diagnosis, the sensitivity and the specificity was 44.0% and 93.4%, respectively on lymph node basis and 42.9% and 81.8%, respectively on patient basis when cutoff value of short axis was set at 10 mm. In PET/CT diagnosis, the sensitivity and the specificity was 52.0% and 87.5%, respectively on lymph node basis and 52.4% and 76.1%, respectively on patient basis when cutoff value of SUVmax was set at 2.5. There were 33 patients that showed a pattern of symmetric uptake in the bilateral hilum. In the analysis of the other 76 patients without symmetric uptake, the sensitivity and the specificity was 62.5% and 85.0%, respectively on lymph node basis and 56.3% and 90.0%, respectively on patient basis when cutoff value of SUVmax was set at 2.5. Conclusion. In the image diagnosis of N1 metastasis, PET/CT was superior in sensitivity but inferior in specificity to CT. It should be remained that a pattern of symmetric uptake dose not contribute to precise diagnosis.
key words: Lung cancer, N1 lymph node metastasis, PET/CT
Received: April 16, 2014
Accepted: July 5, 2014
JJLC 54 (4): 180-186, 2014
