Zentralbl Chir 2018; 143(S 01): S89
DOI: 10.1055/s-0038-1668356
Freie Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Preoperative hiliar and mediastinal lymph node staging in patients with suspected or diagnosed lung cancer: Accuracy of FDG-PET/CT. A retrospective cohor study of 162 patients

F Damirov
1   Chirurgische Klinik, Universitätsklinikum Mannheim; Spezielle Chirurgische Onkologie und Thoraxchirurgie, Medizinische Fakultät Mannheim, Universität Heidelberg
,
I Karampinis
1   Chirurgische Klinik, Universitätsklinikum Mannheim; Spezielle Chirurgische Onkologie und Thoraxchirurgie, Medizinische Fakultät Mannheim, Universität Heidelberg
,
L Pilz
2   Medizinische Statistik, Universitätsklinikum Mannheim; Biomathematik, Medizinische Fakultät Mannheim, Universität Heidelberg
,
K Büsing
3   Institut für Klinische Radiologie und Nuklearmedizin, Universitätsklinikum Mannheim; Medizinische Fakultät Mannheim, Universität Heidelberg
,
T Gaiser
4   Pathologisches Institut, Universitätklinikum Mannheim; Medizinische Fakultät Mannheim, Universität Heidelberg
,
A Müller
5   III. Medizinische Klinik, Onkologie, Universitätklinikum Mannheim; Medizinische Fakultät Mannheim, Universität Heidelberg
,
J Michels
6   I. Medizinische Klinik, Pneumologie, Universitätsklinikum Mannheim; Medizinische Fakultät Mannheim, Universität Heidelberg
,
P Hohenberger
1   Chirurgische Klinik, Universitätsklinikum Mannheim; Spezielle Chirurgische Onkologie und Thoraxchirurgie, Medizinische Fakultät Mannheim, Universität Heidelberg
,
E Roessner
1   Chirurgische Klinik, Universitätsklinikum Mannheim; Spezielle Chirurgische Onkologie und Thoraxchirurgie, Medizinische Fakultät Mannheim, Universität Heidelberg
› Author Affiliations
Further Information

Publication History

Publication Date:
05 September 2018 (online)

Also available ateRef
 
 

    Hintergrund:

    The aim of this study was to evaluate the diagnostic accuracy of integrated 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) in hilar and mediastinal lymph node (HMLN) staging of suspected or proven lung cancer.

    Material und Methode:

    We retrospectively analysed 162 consecutive patients with suspected or pathologically proven NSCLC. All patients were potentially resectable and received integrated PET/CT scanning. A total of 138 patients met our inclusion criteria in this study. Pathologic lymph node staging was performed on tissue specimens obtained at endobronchial ultrasound needle biopsy, mediastinoscopy and/or thoracotomy/thoracoscopy. Nodal stations were identified according to the IASLC mapping system. The receiver operating characteristic (ROC) curve was generated to determine the diagnostic efficacy of PET/CT.

    Ergebnis:

    According to PET/CT and histopathological results, 54 patients were misdiagnosed. Postoperatively 32 patients were confirmed as false positive and 22 patients as false negative cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of integrated FDG-PET/CT in detecting HMLN metastases were 46.3% (19/41), 67.0% (65/97), 37.3% (19/51), 74.7% (65/87), and 60.8% (84/138), respectively. The ROC curve showed an area under curve (AUC) of 0.5777. The odds ratio of SUV-max was 1.090 (95%-CI 0.985 – 1.211).

    Schlussfolgerung:

    Our data shows that integrated PET/CT staging provides lower specificity and sensitivity as expected on the basis of available literature. This confirms the ESTS guideline on lymph node staging for PET positive HMLN. But it advocates more invasive staging even for PET negative HMLN.