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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

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...

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Detalles Bibliográficos
Autores principales: Kaseda, Kaoru, Watanabe, Ken‐ichi, Asakura, Keisuke, Kazama, Akio, Ozawa, Yukihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930968/
https://www.ncbi.nlm.nih.gov/pubmed/27385991
http://dx.doi.org/10.1111/1759-7714.12358
Descripción
Sumario: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.