Sathekge Chabi, Maes Justine, Maes Alex, Van de Wiele Christophe
Nuclear Medicine and Nuclear Medicine Research Infrastructure (NuMeRi), Pretoria 0002, South Africa; Department of Chemical Pathology, University of Pretoria, Pretoria 0002, South Africa.
Department of Chemical Pathology, University of Pretoria, Pretoria 0002, South Africa.
Semin Nucl Med. 2025 Mar;55(2):167-174. doi: 10.1053/j.semnuclmed.2025.01.002. Epub 2025 Feb 28.
In non-small cell lung carcinoma (NSCLC) carcinoma, the CT-part of the FDG PET/CT examination is of primary importance for T (tumor)-status assessment, while information derived from the primary tumor on the FDG-part of the examination may provide additional information on N- (lymph node) status. FDG PET/CT imaging was shown to have an overall sensitivity of 85% and a specificity of 84% for identifying LN involvement in NSCLC. Parameters that may predict the presence and quantify the risk of LN-involvement in NSCLC missed on FDG PET/CT imaging are tumor size and its increase over time, tumor differentiation degree, the number of days elapsed from the time of initial diagnosis, an adenocarcinoma subtype, a central versus peripheral location of the primary tumor and a solid versus mixed solid-ground glass radiologic character. Nomograms incorporating several of these variables have been published and made available for clinical usage. Furthermore, FDG PET/CT imaging was shown to have an overall higher sensitivity for identifying extra-thoracic metastases than convential morphological imaging and this especially for bone and adrenal lesions. In small cell lung carcinoma (SCLC), limited available data have shown FDG PET/CT imaging to be systematically more accurate for staging purposes when compared to conventional staging and to lead to a change in disease stage (limited versus extensive disease) in up to 15% of SCLC-patients.
在非小细胞肺癌（NSCLC）中，FDG PET/CT检查的CT部分对于T（肿瘤）状态评估至关重要，而检查的FDG部分从原发肿瘤获得的信息可能会提供有关N（淋巴结）状态的额外信息。FDG PET/CT成像在识别NSCLC中的淋巴结受累方面显示出总体敏感性为85%，特异性为84%。可能预测FDG PET/CT成像遗漏的NSCLC中淋巴结受累的存在并量化其风险的参数包括肿瘤大小及其随时间的增加、肿瘤分化程度、自初始诊断时间起经过的天数、腺癌亚型、原发肿瘤的中央与外周位置以及实性与混合实性磨玻璃影像学特征。纳入这些变量中的几个的列线图已经发表并可供临床使用。此外，与传统形态学成像相比，FDG PET/CT成像在识别胸外转移方面总体具有更高的敏感性，尤其是对于骨和肾上腺病变。在小细胞肺癌（SCLC）中，有限的现有数据表明，与传统分期相比，FDG PET/CT成像在分期目的方面系统地更准确，并且在高达15%的SCLC患者中导致疾病分期（局限期与广泛期）的改变。
