Diagnosis of the presence of lymph node metastasis and decision of operative indication using fluorodeoxyglucose-positron emission tomography and computed tomography in patients with primary lung cancer
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Objectives : We evaluate whether integrated fluorodeoxyglucose-positron emissiontomography and computed tomography (FDG-PET/CT) scan can diagnose the presenceof lymph node metastasis more accurately than computed tomography (CT) scanalone. Methods : Forty-two patients with lung cancer preoperatively underwent integratedPET/CT scan using FDG and CT scan and underwent pulmonary resection and lymphnode dissection. We judged cases as lymph node metastasis if the lymph node visuallyaccumulated FDG at PET/CT scan and measured 1 cm or greater in the short axis at CTscan. We retrospectively analyzed whether our judgments in each modality were consistentwith the pathological diagnosis. Results : Two-hundred and seventeen stations oflymph node were dissected and 21 stations (9.7%) were histologically diagnosed as positivemetastasis. Thirty-two stations of lymph node visually accumulated FDG at PET/CTscan and 17 stations measured 1 cm or greater in the short axis at CT scan. Concerningthe diagnosis of lymph node metastasis, PET/CT scan showed significantly higher sensitivitythan CT scan (81% vs. 48%, p=0.024). The false-positive rate was significantly highin PET-positive lymph nodes measuring less than 1 cm in diameter. There were 4 falsenegativelymph nodes with both scans. All of these were less than 7 mm in diameter andhad a low percentage of metastatic foci in the lymph node. Concerning the diagnosis ofN staging, there was no significant difference between PET/CT scan and CT scan (83%vs. 69%, p=0.124). However, the identification of N2 disease at PET/CT scan was significantlymore accurate than that at CT scan (100% vs. 38%, p=0.031). Conclusions : PET/CTis superior to CT scan in lymph node staging. However, because the false-positive rate ishigh in PET-positive lymph nodes measuring less than 1 cm in diameter, we think thatclinical background should be considered and other modalities or histological examinationsshould be undertaken if necessary.
論文 | ランダム
- 日本人留学生の留学動機に関するジェンダー学的考察--ロンドン大学大学院生を対象とした事例研究
- 郡司譜第考
- 郡司職分田試論
- 擬郡司帳管見--郡司任用日程の変遷
- 宣旨による郡司の任用--延喜式部式奉大臣宣条を手がかりに