Identification of false‐negative and false‐positive diagnoses of lymph node metastases in non‐small cell lung cancer patients staged by integrated 18F‐fluorodeoxyglucose‐positron emission tomography/computed tomography: A retrospective cohort study. Issue 4 (5th May 2016)

• Record Type: Journal Article
• Authors: Kaseda, Kaoru; Watanabe, Ken‐ichi; Asakura, Keisuke; Kazama, Akio; Ozawa, Yukihiko
• Is Part Of: Thoracic cancer. Volume 7:Issue 4(2016)
• Page Start: 473
• Page End: 480
• Publication Date: 2016-05-05
• Subjects: Lymph node staging -- non‐small cell lung cancer -- positron emission tomography; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.12358
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract : Background: The aim of this study was to evaluate the diagnostic accuracy of integrated 18 F‐fluorodeoxyglucose positron emission tomography/computed tomography (FDG‐PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non‐small cell lung cancer (NSCLC), and to investigate potential risk factors for false‐negative and false‐positive HMLN metastases. Methods: We examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG‐PET/CT. Risk factors for false‐negative and false‐positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG‐PET/CT in detecting HMLN metastases were 47.4%, 91.0%, 56.3%, 87.7%, and 82.5%, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor ( P = 0.042), adenocarcinoma ( P = 0.003), and tumor size ( P = 0.017) were risk factors for false‐negative HMLN metastases, and history of lung disease ( P = 0.006) and tumor location (central; P = 0.025) were risk factors for false‐positive HMLN metastases. Conclusions: The present study identified risk factors for false‐negative and false‐positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG‐PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound‐guided transbronchial needle aspiration.