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The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions

Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate the radiological features and the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes with anthracosis or sq...

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Autores principales: Bulut, Sertan, Celik, Deniz, Karamanlı, Harun, Aktas, Zafer, Özmen, Özlem, Ertürk, Hakan, Gürçay, Nesrin, Biber, Çiğdem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184177/
https://www.ncbi.nlm.nih.gov/pubmed/35698679
http://dx.doi.org/10.7759/cureus.24884
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author Bulut, Sertan
Celik, Deniz
Karamanlı, Harun
Aktas, Zafer
Özmen, Özlem
Ertürk, Hakan
Gürçay, Nesrin
Biber, Çiğdem
author_facet Bulut, Sertan
Celik, Deniz
Karamanlı, Harun
Aktas, Zafer
Özmen, Özlem
Ertürk, Hakan
Gürçay, Nesrin
Biber, Çiğdem
author_sort Bulut, Sertan
collection PubMed
description Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate the radiological features and the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes with anthracosis or squamous cell lung cancer metastasized. Methodology Patients diagnosed with anthracosis or squamous cell lung cancer with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) between January 1, 2015, and November 15, 2020, in a tertiary hospital were enrolled. The squamous cell subtype of lung cancer was selected due to its association with tobacco use, biomass, and air pollution. Anthracosis may occur due to the same etiologic reasons. Results A total of 190 patients met the study enrollment criteria, of which 86 were diagnosed with anthracosis and 33 with squamous cell lung cancer lymph metastasis. Median values for short axis, long axis, SUVmax, shape features, and presence of calcification were found significantly different between the groups. In receiver operating characteristic (ROC) analysis, the SUVmax cut-off value was calculated as 6.61. With this cutoff value, the negative predictive value (NPV) was 92.5% and the positive predictive value (PPV) was 54% for differentiating anthracosis and malignant lymph nodes metastasis. Conclusions We conclude that the evaluation of the shape and metabolic activities of the anthracotic lymph nodes detected by PET/CT together with EBUS-TBNA granted a more accurate staging of the patients and more cancer patients will benefit from surgical treatment.
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spelling pubmed-91841772022-06-12 The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions Bulut, Sertan Celik, Deniz Karamanlı, Harun Aktas, Zafer Özmen, Özlem Ertürk, Hakan Gürçay, Nesrin Biber, Çiğdem Cureus Radiology Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate the radiological features and the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes with anthracosis or squamous cell lung cancer metastasized. Methodology Patients diagnosed with anthracosis or squamous cell lung cancer with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) between January 1, 2015, and November 15, 2020, in a tertiary hospital were enrolled. The squamous cell subtype of lung cancer was selected due to its association with tobacco use, biomass, and air pollution. Anthracosis may occur due to the same etiologic reasons. Results A total of 190 patients met the study enrollment criteria, of which 86 were diagnosed with anthracosis and 33 with squamous cell lung cancer lymph metastasis. Median values for short axis, long axis, SUVmax, shape features, and presence of calcification were found significantly different between the groups. In receiver operating characteristic (ROC) analysis, the SUVmax cut-off value was calculated as 6.61. With this cutoff value, the negative predictive value (NPV) was 92.5% and the positive predictive value (PPV) was 54% for differentiating anthracosis and malignant lymph nodes metastasis. Conclusions We conclude that the evaluation of the shape and metabolic activities of the anthracotic lymph nodes detected by PET/CT together with EBUS-TBNA granted a more accurate staging of the patients and more cancer patients will benefit from surgical treatment. Cureus 2022-05-10 /pmc/articles/PMC9184177/ /pubmed/35698679 http://dx.doi.org/10.7759/cureus.24884 Text en Copyright © 2022, Bulut et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Radiology
Bulut, Sertan
Celik, Deniz
Karamanlı, Harun
Aktas, Zafer
Özmen, Özlem
Ertürk, Hakan
Gürçay, Nesrin
Biber, Çiğdem
The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title_full The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title_fullStr The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title_full_unstemmed The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title_short The Differentiation of Metastatic Mediastinal Lymph Nodes From Benign Hypermetabolic Lesions
title_sort differentiation of metastatic mediastinal lymph nodes from benign hypermetabolic lesions
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184177/
https://www.ncbi.nlm.nih.gov/pubmed/35698679
http://dx.doi.org/10.7759/cureus.24884
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