FDG-PET parameters predicting mediastinal malignancy in lung cancer
Serra Fortuny, M. (Universitat Autònoma de Barcelona. Departament de Medicina)
Gallego, Miguel (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Berna, Lluís (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Montón, Concepción (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Vigil Giménez, Laura (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Masdeu, María José (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Fernández-Villar, A. (Complexo Hospitalario Universitario de Vigo)
Botana-Rial, M (Complexo Hospitalario Universitario de Vigo)
Cordovilla, Rosa (Complejo Asistencial de Salamanca)
García-Luján, Ricardo (Hospital Universitario 12 de Octubre (Madrid))
Cases Viedma, Enrique (Hospital Universitari i Politècnic La Fe (València))
Monsó, Eduard (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))

Date:	2016
Abstract:	Staging of mediastinal lymph nodes in non-small cell lung cancer (NSCLC) is mandatory. The maximum Standard Uptake Value (SUVmax) obtained using F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is the best non-invasive technique available for this evaluation, but its performance varies from center to center. The aim of the present study was to identify FDG-PET predictors of mediastinal malignancy that are able to minimize intercenter variability and improve the selection of subsequent staging procedures. A multicenter study of NSCLC patients staged through FDG-PET and endobronchial ultrasonography with needle aspiration (EBUS-NA) was performed using therapeutic surgery with systematic nodal dissection as gold standard. Intercenter variability and predictive power for mediastinal malignancy of different FDG-PET measures were assessed, as well as the role of these measures for selecting additional staging procedures. One hundred and twenty-one NSCLC patients, of whom 94 (72%) had ≥1 hypermetabolic spots in the mediastinum, were included in the study. Mean SUVmax of the primary tumor was 12. 3 (SD 6. 3), and median SUVmax of the highest hypermetabolic spots in the mediastinum was 3. 9 (IQR 2. 4-7). Variability of FDG-PET measures between hospitals was statistically significant (p = 0. 016 and p < 0. 001 respectively), but lost significance when SUVmax in the mediastinum was expressed as a ratio or a subtraction from the primary tumor (SUVmax mediastinum/tumor, p = 0. 083; and SUVmax mediastinum - tumor, p = 0. 428 respectively). SUVmax mediastinum/tumor showed higher accuracy in the ROC analysis (AUC 0. 77 CI 0. 68-0. 85, p < 0. 001), and showed predictive power for mediastinal malignancy when using a 0. 4 cutoff (OR 6. 62, 95%CI 2. 98-14. 69). Sensitivities and negative predictive values of clinical staging through EBUS-NA attained values ranging between 57% and 92% after FDG-PET, which improved with additional techniques when the tumor had a diameter >3 cm and/or a SUVmax mediastinum/tumor ratio >0. 4. The SUVmax mediastinum/tumor ratio is a good predictor of regional tumor extension in NSCLC. This measure is not influenced by intercenter variability and has an accuracy of over 70% for the identification of malignancy when using a 0. 4 cutoff.
Grants:	Instituto de Salud Carlos III PI12/02040
Note:	Altres ajuts: Sociedad Española de Neumología y Cirugía Torácica 226/2012
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	FDG-PET ; F-18 fluorodeoxyglucose positron emission tomography ; Lung cancer ; NSCLC ; EBUS-NA ; Endobronchial ultrasonography with needle aspiration
Published in:	BMC Pulmonary Medicine, Vol. 16 (december 2016) , ISSN 1471-2466

DOI: 10.1186/s12890-016-0338-6
PMID: 27931198

9 p, 733.9 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles