Histology of the Primary Tumor Correlates with False Positivity of Integrated 18F-FDG-PET/CT Lymph Node Staging in Resectable Lung Cancer Patients

This study aimed to evaluate the diagnostic accuracy and false positivity rate of lymph node (LN) staging assessed by integrated 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) in patients with operable lung cancer to the tumor histology. In total, 129 consecutive patie...

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Bibliographic Details
Main Authors: Fuad Damirov, Mircea Gabriel Stoleriu, Farkhad Manapov, Karen Büsing, Julia Dorothea Michels, Gerhard Preissler, Rudolf A. Hatz, Peter Hohenberger, Eric D. Roessner
Format: Article
Language:English
Published: MDPI AG 2023-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/13/11/1893
Description
Summary:This study aimed to evaluate the diagnostic accuracy and false positivity rate of lymph node (LN) staging assessed by integrated 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) in patients with operable lung cancer to the tumor histology. In total, 129 consecutive patients with non-small-cell lung cancer (NSCLC) undergoing anatomical lung resections were included. Preoperative LN staging was evaluated in the relationship to the histology of the resected specimens (group 1: lung adenocarcinoma/LUAD; group 2: squamous cell carcinoma/SQCA). Statistical analysis was performed by the Mann–Whitney U-test, the chi<sup>2</sup> test, and binary logistic regression analysis. To establish an easy-to-use algorithm for the identification of LN false positivity, a decision tree including clinically meaningful parameters was generated. In total, 77 (59.7%) and 52 (40.3%) patients were included in the LUAD and SQCA groups, respectively. SQCA histology, non-G1 tumors, and tumor SUVmax > 12.65 were identified as independent predictors of LN false positivity in the preoperative staging. The corresponding ORs and their 95% CIs were 3.35 [1.10–10.22], <i>p</i> = 0.0339; 4.60 [1.06–19.94], <i>p</i> = 0.0412; and 2.76 [1.01–7.55], and <i>p</i> = 0.0483. The preoperative identification of false-positive LNs is an important aspect of the treatment regimen for patients with operable lung cancer; thus, these preliminary findings should be further evaluated in larger patient cohorts.
ISSN:2075-4418