Department of Radiation Oncology and Shandong Province Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
Clin Nucl Med. 2011 Jun;36(6):429-33. doi: 10.1097/RLU.0b013e3182173810.
To evaluate the efficacy of dual-time-point F-18 fluorodeoxyglucose positron emission tomography (FDG PET)/ computed tomography (CT) for mediastinal nodal staging in non-small-cell lung cancer patients with lung comorbidity.
Fifty-three pathologically proven non-small-cell lung cancer patients with pulmonary comorbidity and 49 patients as controlled group without comorbidity were enrolled. PET/CT was performed at 1-hour (whole body) post-FDG injection and repeated 2 hours (thoracic) after injection. All patients received radical surgery with system mediastinal lymph node (LN) dissection. The results of LN detection by single-time-point and dual-time-point scan were compared with the histopathologic findings.
On a per-patient basis, in patients with pulmonary comorbidity, the sensitivity, specificity, accuracy, and positive predictive values (PPV), and negative predictive values of single-time-point scan were 87.5%, 59.5%, 67.9%, 48.3%, and 91.7%, respectively. Those values of dual-time-point scan were 93.8%, 67.6%, 75.5%, 55.6%, and 96.2%, respectively. In patients without comorbidity, dual-time-point scan was similar in those values to single-time-point. On a per-nodal station basis, the specificity, accuracy, and PPV of dual-time-point scan were better than those of single-time-point with statistically significant differences (P = 0.017, 0.002, and 0.027, respectively) in patients with pulmonary comorbidity, but the difference was not statistically significant in patients with no pulmonary comorbidity.
Dual-time-point FDG PET/CT is more effective for mediastinal nodal staging than single-time-point in patients with pulmonary comorbidity. Dual-time-point scan was useful for diagnosis of mediastinal LN metastases in reducing the false-positive results in all patients, but improved specificity, accuracy, and PPV only in patients with pulmonary comorbidity.
评估氟代脱氧葡萄糖正电子发射断层扫描（FDG PET）/计算机断层扫描（CT）双时相在合并肺部疾病的非小细胞肺癌纵隔淋巴结分期中的疗效。
纳入 53 例经病理证实的合并肺部疾病的非小细胞肺癌患者和 49 例无合并症的对照组患者。FDG 注射后 1 小时（全身）和注射后 2 小时（胸部）进行 PET/CT 检查。所有患者均接受根治性手术和系统纵隔淋巴结（LN）清扫。比较单时相和双时相扫描对 LN 的检测结果与组织病理学发现。
在合并肺部疾病的患者中，单时相扫描的患者检出率、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）分别为 87.5%、59.5%、67.9%、48.3%和 91.7%。双时相扫描的这些值分别为 93.8%、67.6%、75.5%、55.6%和 96.2%。在无合并症的患者中，双时相扫描的这些值与单时相相似。在以淋巴结站为基础的情况下，在合并肺部疾病的患者中，双时相扫描的特异性、准确性和 PPV 均优于单时相，差异有统计学意义（P = 0.017、0.002 和 0.027），但在无肺部合并症的患者中差异无统计学意义。
双时相 FDG PET/CT 对合并肺部疾病的患者纵隔淋巴结分期比单时相更有效。双时相扫描在减少所有患者假阳性结果的基础上，对纵隔 LN 转移的诊断有用，但仅在合并肺部疾病的患者中提高了特异性、准确性和 PPV。
