Korean J Thorac Cardiovasc Surg.  2003 Feb;36(2):79-85.

Efficacy of Positron Emission Tomography in Diagnosing Pulmonary Tumor and Staging of Lung Cancer: Comparing to Computed Tomography

• Kim OG
• Choh JH
• Sung SW

Abstract

BACKGROUND: Diagnosing and determining the stage of lung cancer by means of positron emission tomography (PET) has been proven valuable because of the limitations of diagnosis by computed tomography (CT). We compared the efficacy of PET with that of CT in diagnosing pulmonary tumor and staging of lung cancer. MATERIAL AND METHOD: We performed F-18 FDG PET to determine the malignancy and the staging on patients who have been suspicious or were diagnosed as lung cancer by chest X-ray and CT. The findings of PET and of CT of 41 patients (male, 29; female, 12; mean age, 59) were compared with pathologic findings obtained from a mediastinoscopy and thoracotomy. RESULT: Out of 41 patients, 35 patients had malignant lesions (squamous cell carcinoma 19 cases, adenocarcinoma 14 cases, adenosquamous cell carcinoma 2 cases) and 6 patients had benign lesions. Diagnosing of lung cancer, the sensitivity, specificity and accuracy of CT and PET were the same for two method and the numbers were 100 %, 50 %, and 92.7 % respectively. Eighteen LN groups out of 108 mediastinal LN groups who recieved histologic examination proved to be malignant. Pathologic lymph node (LN) stage was N0-N1 31 cases, N2 8 cases, N3 2 cases. The correct identification of the nodal staging with CT, PET scans were 31 cases (75.6%), 28 cases (68.3%) respectively. The LN group was underestimated in each 6 cases of CT and PET. In 4 cases of CT and 7 cases of PET, they were overestimated in compare to histologic diagnosis. In the detection of mediastinal LN groups invasion, the sensitivity, specificity and accuracy of CT were 39.8 %, 93.3 %, and 84.3 % respectively. For PET, they were 61.1 %, 90.0 %, and 85.2 %. When two methods considered together (CT+PET), they were increased to 77.8 %, 93.3 %, and 90.7 % respectively.
Conclusion
PET appears to be similar to CT in the diagnosis and the nodal taging of pulmonary tumor. Two tests may stage patients with lung cancer more accurately than CT alone.

Keyword

Lung neoplasm; Tomography; X-ray computed; emission computed

MeSH Terms

Adenocarcinoma
Diagnosis
Electrons*
Female
Humans
Lung Neoplasms*
Lung*
Lymph Nodes
Mediastinoscopy
Positron-Emission Tomography*
Sensitivity and Specificity
Thoracotomy
Thorax