Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging
OBJECTIVES: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2011-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011001100009 |
| _version_ | 1811229785103269888 |
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| author | Juliana Muniz Miziara Euclides Timóteo da Rocha José Elias Abrão Miziara Gustavo Fabene Garcia Maria Izilda Previato Simões Marco Antônio Lopes Lígia Maria Kerr Carlos Alberto Buchpiguel |
| author_facet | Juliana Muniz Miziara Euclides Timóteo da Rocha José Elias Abrão Miziara Gustavo Fabene Garcia Maria Izilda Previato Simões Marco Antônio Lopes Lígia Maria Kerr Carlos Alberto Buchpiguel |
| author_sort | Juliana Muniz Miziara |
| collection | DOAJ |
| description | OBJECTIVES: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using 99mTc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. METHODS: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with 99mTc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. RESULTS: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for 99mTc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative predictive values of 67.7% and 91.2%, respectively. CONCLUSION: Single-photon emission computed tomography/computed tomography with 99mTc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma. |
| first_indexed | 2024-04-12T10:19:55Z |
| format | Article |
| id | doaj.art-1f889258eb1e4372b5b4ee85e41a4a4f |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-04-12T10:19:55Z |
| publishDate | 2011-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-1f889258eb1e4372b5b4ee85e41a4a4f2022-12-22T03:37:07ZengElsevier EspañaClinics1807-59321980-53222011-01-0166111901190910.1590/S1807-59322011001100009Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imagingJuliana Muniz MiziaraEuclides Timóteo da RochaJosé Elias Abrão MiziaraGustavo Fabene GarciaMaria Izilda Previato SimõesMarco Antônio LopesLígia Maria KerrCarlos Alberto BuchpiguelOBJECTIVES: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using 99mTc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. METHODS: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with 99mTc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. RESULTS: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for 99mTc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative predictive values of 67.7% and 91.2%, respectively. CONCLUSION: Single-photon emission computed tomography/computed tomography with 99mTc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011001100009Lung cancerLymph nodesMIBISingle-photon emission computed tomographyFunctional imaging |
| spellingShingle | Juliana Muniz Miziara Euclides Timóteo da Rocha José Elias Abrão Miziara Gustavo Fabene Garcia Maria Izilda Previato Simões Marco Antônio Lopes Lígia Maria Kerr Carlos Alberto Buchpiguel Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging Clinics Lung cancer Lymph nodes MIBI Single-photon emission computed tomography Functional imaging |
| title | Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging |
| title_full | Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging |
| title_fullStr | Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging |
| title_full_unstemmed | Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging |
| title_short | Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging |
| title_sort | preoperative nodal staging of non small cell lung cancer using 99mtc sestamibi spect ct imaging |
| topic | Lung cancer Lymph nodes MIBI Single-photon emission computed tomography Functional imaging |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011001100009 |
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