PET-CT in mediastinal staging of non-small cell lung cancer: analysis of false results.

PURPOSE

To analyse the risk and factors associated with false-negative (FN) and false-positive (FP) positron emission tomography-computed tomography (PET-CT) results in the mediastinal staging of non-small cell lung cancer.

MATERIAL AND METHODS

This retrospective cohort study analysed data from a prospective database. It included patients with lung cancer who underwent preoperative staging with PET-CT, endobronchial ultrasound, and endoscopic ultrasound, followed by curative-intent anatomical lung resection with systematic lymph node dissection. Statistical analyses were performed to identify factors associated with FN and FP PET-CT results.

RESULTS

Data from 781 patients were analysed. FN results were significantly associated with more advanced PET-CT-based stages and CT-based stage IIB. FP results were significantly associated with male sex, adenocarcinoma histology, CT-based disease stage, and SUV values of the primary tumour and lymph nodes.

CONCLUSIONS

False-negative PET-CT results in the diagnosis of mediastinal lymph node involvement were more likely to occur in PET-CT-based stages IB and IIB and less likely to occur in stage IIIA. FP results were more likely to be expected in men, with higher SUV values of the primary tumour and a more advanced CT-based stage of the disease.