Ann Thorac Oncol Res | Volume 2, Issue 1 | Research Article | Open Access
Lawrence Okiror1, Andrea Bille1* and Ettore Pellosi2
1Department of Thoracic Surgery, Guy’s and St Thomas’ Hospitals, UK
2IRMET PET Centre, Italy
*Correspondance to: Andrea Bille
Fulltext PDFIntroduction: Therapeutic options and prognosis for patients with Non-Small Cell Lung Cancer (NSCLC) are mainly determined by the metastatic spread of disease the mediastinal lymph nodes. Non-invasive staging using F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT). This review aims to assess the accuracy, sensitivity and specificity of FDG-PET/CT imaging for detecting mediastinal lymph node involvement in patients with potentially resectable NSCLC.
Methods: A systematic literature search was conducted to identify eligible full-text articles that were then assessed for quality and data were extracted.
Results: The search identified 45 eligible studies with a total of 5824 patients (median 206, range 23 to 674). The median accuracy of all studies was 83.5% (range 11% to 97%). The median (range) sensitivity, specificity, positive predictive value and negative predictive values of PET-CT at detecting lymph node metastasis in NSCLC were 72% (39% to 97%), 87% (37% to 100%), 64% (13% to 100%) and 91% (81% to 99%) respectively. Sensitivity, specificity and accuracy of PET-CT diagnosis of metastatic lymph nodes were influenced by histologic subtype of NSCLC.
Conclusion: Whilst FDG-PET/CT is helpful in screening for presence of metastatic mediastinal lymph node involvement, its accuracy, sensitivity and specificity is not high enough to justify reliance on FDG-PET/CT scanning alone to make clinical decisions about whether to offer surgery as a single option for patients with potentially resectable NSCLC. The accuracy of FDG-PET/CT should be monitored against the gold-standard of histologic confirmation.
PET-CT; Non-small cell lung cancer; Lymph node metastases
Okiror L, Bille A, Pellosi E. Systematic Review of Studies Reporting on the Accuracy of PET-CT in Detecting Intra Thoracic Lymph Node Metastasis in Patients with NSCLC. Ann Thorac Oncol Res. 2018; 1(2): 1008.