Efficacy of positron emission tomography in diagnosis of lateral lymph node metastases in patients with rectal Cancer: a retrospective study

BMC Cancer

Shiki Fujino¹  Takayuki Ogino¹  Hirofumi Yamamoto¹  Norikatsu Miyoshi¹  Tsunekazu Mizushima¹  Mamoru Uemura¹  Hidetoshi Eguchi¹  Tsuyoshi Hata¹  Hidekazu Takahashi¹  Taishi Hata¹  Ryohei Yukimoto¹  Yuichiro Doki¹  Takahiro Tsuboyama²  Akira Kida³  Mamoru Furuyashiki³ 

[1] Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita City, 565-0871, Osaka, Japan;Department of Radiology, Graduate School of Medicine, Osaka University, Osaka, Japan;Department of Radiology, Jinsenkai MI Clinic, Toyonaka, Osaka, Japan;

关键词: Positron emission tomography;    Lateral pelvic lymph node;    Rectal cancer;    Maximum standardized uptake value;    metastases;   

DOI  :  10.1186/s12885-021-08278-6

来源: Springer

【 摘 要 】

BackgroundThe presence of lateral pelvic lymph node (LLN) metastasis is an essential prognostic factor in rectal cancer patients. Thus, preoperative diagnosis of LLN metastasis is clinically important to determine the therapeutic strategy. The aim of this study was to evaluate the efficacy of preoperative positron emission tomography/computed tomography (PET/CT) in the diagnosis of LLN metastasis.MethodsEighty-four patients with rectal cancer who underwent LLN dissection at Osaka University were included in this study. The maximum standardized uptake value (SUVmax) of the primary tumor and LLN were preoperatively calculated using PET/CT. Simultaneously, the short axis of the lymph node was measured using multi-detector row computed tomography (MDCT). The presence of metastases was evaluated by postoperative pathological examination.ResultsOf the 84 patients, LLN metastases developed in the left, right, and both LLN regions in 6, 7, and 2 patients, respectively. The diagnosis of the metastases was predicted with a sensitivity of 82%, specificity of 93%, positive predictive value of 58%, negative predictive value of 98%, false positive value of 7%, and false negative value of 18% when the cutoff value of the LLN SUVmax was set at 1.5. The cutoff value of the short axis set at 7 mm on MDCT was most useful in diagnosing LLN metastases, but SUVmax was even more useful in terms of specificity.ConclusionsThe cutoff value of 1.5 for lymph node SUVmax in PET is a reasonable measure to predict the risk of preoperative LLN metastases in rectal cancer patients.

【 授权许可】

CC BY