Gupta N C, Graeber G M, Bishop H A
West Virginia University PET Center and Department of Surgery, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA.
Chest. 2000 Mar;117(3):773-8. doi: 10.1378/chest.117.3.773.
Our objective was to determine if positron emission tomography (PET) with fluorodeoxyglucose (FDG; PET-FDG) imaging is equally efficacious in detection of metastases in small and large mediastinal lymph nodes as compared to CT scanning.
PET-FDG imaging, CT scanning, and histology results of sampled mediastinal lymph nodes were compared in 54 patients of total 118 patients studied. Efficacy of PET and CT was determined and compared in small (< 1 cm), intermediate (1 to 3 cm), and large (> 3 cm) mediastinal lesions.
PET was accurate in 94% of patients in characterizing "N" disease as compared to 61% with CT. Overall, sensitivity, specificity, and accuracy of PET for staging mediastinal lymph nodes (n = 168 in 54 patients) was 96, 93, and 94%, as compared to 68, 65, and 66% with CT. Positive and negative predictive value of PET in detecting mediastinal adenopathy was 86% and 98%, as compared to 47% and 82% with CT, respectively. PET was also highly reliable and accurate for detecting lymph nodes < 1 cm, 1 to 3 cm, and > 3 cm in size with superior efficacy than CT. Sensitivity, specificity, and accuracy of PET for detecting malignancy in lymph node lesions < 1 cm in size was 97, 82, and 95%, respectively.
PET-FDG imaging is equally reliable and accurate for detecting disease in small and large lymph node lesions in patients with suspected or proven lung cancer with better efficacy than CT.
我们的目标是确定与CT扫描相比，使用氟脱氧葡萄糖（FDG）进行正电子发射断层扫描（PET；PET-FDG）成像在检测纵隔小淋巴结和大淋巴结转移方面是否同样有效。
在总共118例接受研究的患者中，对54例患者的PET-FDG成像、CT扫描以及纵隔淋巴结取样的组织学结果进行了比较。确定并比较了PET和CT在小（<1 cm）、中（1至3 cm）和大（>3 cm）纵隔病变中的效能。
与CT的61%相比，PET在94%的患者中准确地对“N”疾病进行了特征描述。总体而言，PET对纵隔淋巴结分期（54例患者共168个淋巴结）的敏感性、特异性和准确性分别为96%、93%和94%，而CT分别为68%、65%和66%。PET检测纵隔淋巴结病的阳性和阴性预测值分别为86%和98%，而CT分别为47%和82%。PET在检测大小<1 cm、1至3 cm和>3 cm的淋巴结方面也高度可靠且准确，其效能优于CT。PET检测大小<1 cm的淋巴结病变中恶性肿瘤的敏感性、特异性和准确性分别为97%、82%和95%。
对于疑似或确诊肺癌患者，PET-FDG成像在检测小淋巴结病变和大淋巴结病变中的疾病方面同样可靠且准确，其效能优于CT。
