Diagnostic Accuracy of Virtual 18F-FDG PET/CT Bronchoscopy for the Detection of Lymph Node Metastases in Non–Small Cell Lung Cancer Patients

Journal of Nuclear Medicine

Bernhard Geiger¹  Till A. Heusner¹  Verena Hartung¹  Carolin Riegger¹  Jon Treffert¹  Michael Forsting¹  Sandra Julia Rosenbaum-Krumme¹  Gerald Antoch¹  Michael Herbrik¹ 

关键词: virtual bronchoscopy;    ¹⁸F-FDG;    PET/CT;    bronchial carcinoma;    lung cancer;    non–small cell lung cancer;   

DOI  :  10.2967/jnumed.111.092593

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The aim of this study was to determine the diagnostic accuracy of 18F-FDG PET/CT bronchoscopy for the detection of regional lymph node metastases in non–small cell lung cancer (NSCLC) patients; potential differences in the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), short-axis diameter, and distance to the airways when comparing true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) lymph nodes; the smallest bronchus diameter accessible by virtual bronchoscopy; and the duration from the start of the virtual 18F-FDG PET/CT bronchoscopy viewing tool until the images were displayed. Methods: Sixty-one consecutive NSCLC patients (mean age ± SD, 58 ± 10 y) underwent whole-body 18F-FDG PET/CT. From these data, virtual 18F-FDG PET/CT bronchoscopies were reconstructed. The duration from the start of the tool until the display of virtual bronchoscopy images was determined. The diagnostic accuracy of 18F-FDG PET/CT bronchoscopy for the detection of regional lymph node metastases was evaluated on a lesion basis. Axial 18F-FDG PET/CT scans served as the standard of reference. The SUVmax, SUVmean, short-axis diameter, and distance to the airways of regional lymph nodes were measured. Lymph nodes were classified as TP, FP, TN, and FN. The smallest bronchus diameter accessible by 18F-FDG PET/CT bronchoscopy was measured. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of virtual 18F-FDG PET/CT bronchoscopy for the detection of lymph node metastases were 76%, 87%, 85%, 79%, and 81%, respectively. The differences between the SUVmax, SUVmean, short-axis diameter, and distance to the airways of TP and FP as well as TN and FN lymph nodes were statistically significant (P < 0.05). The mean smallest diameter of accessible bronchi by 18F-FDG PET/CT bronchoscopy was 3 mm. The mean time duration from the start of the virtual 18F-FDG PET/CT bronchoscopy tool until the display of the images was 22 ± 7 s. Conclusion: Virtual fly-through 3-dimensional 18F-FDG PET/CT bronchoscopy yields a high diagnostic accuracy for the detection of regional lymph node metastases and has access to bronchi even in the periphery of the lung. High SUVmax, high SUVmean, large small-axis diameter, and short distance to the airways aid detection of lymph node metastases with 18F-FDG PET/CT bronchoscopy.

【 授权许可】

Unknown