A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer
<sup>18</sup>F-FDG positron emission tomography with computed tomography (PET/CT) is a standard imaging modality for the nodal staging of non-small cell lung cancer (NSCLC). To improve the accuracy of pre-operative staging, we compare the staging accuracy of mediastinal lymph node (LN) s...
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MDPI AG
2023-03-01
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| Online Access: | https://www.mdpi.com/2075-4418/13/7/1209 |
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| author | Maha AlRasheedi Sai Han Helene Thygesen Matt Neilson Fraser Hendry Ahmed Alkarn John D. Maclay Hing Y. Leung |
| author_facet | Maha AlRasheedi Sai Han Helene Thygesen Matt Neilson Fraser Hendry Ahmed Alkarn John D. Maclay Hing Y. Leung |
| author_sort | Maha AlRasheedi |
| collection | DOAJ |
| description | <sup>18</sup>F-FDG positron emission tomography with computed tomography (PET/CT) is a standard imaging modality for the nodal staging of non-small cell lung cancer (NSCLC). To improve the accuracy of pre-operative staging, we compare the staging accuracy of mediastinal lymph node (LN) standard uptake values (SUV) with four derived SUV ratios based on the SUV values of primary tumours (TR), the mediastinal blood pool (MR), liver (LR), and nodal size (SR). In 2015–2017, 53 patients (29 women and 24 men, mean age 67.4 years, range 53–87) receiving surgical resection have pre-operative evidence of mediastinal nodal involvement (cN2). Among these, 114 mediastinal nodes are resected and available for correlative PET/CT analysis. cN2 status accuracy is low, with only 32.5% of the cN2 cases confirmed pathologically. Using receiver operating characteristic (ROC) curve analyses, a SUVmax of N2 LN performs well in predicting the presence of N2 disease (AUC, 0.822). Based on the respective selected thresholds for each ROC curve, normalisation of LN SUVmax to that for mediastinum, liver and tumour improved sensitivities of LN SUVmax from 68% to 81.1–89.2% while maintaining acceptable specificity (68–70.1%). In conclusion, normalised SUV ratios (particularly LR) improve current pre-operative staging performance in detecting mediastinal nodal involvement. |
| first_indexed | 2024-03-11T05:39:58Z |
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| id | doaj.art-8977148489ec4f46b5eb0d7720bcc254 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T05:39:58Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-8977148489ec4f46b5eb0d7720bcc2542023-11-17T16:29:20ZengMDPI AGDiagnostics2075-44182023-03-01137120910.3390/diagnostics13071209A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung CancerMaha AlRasheedi0Sai Han1Helene Thygesen2Matt Neilson3Fraser Hendry4Ahmed Alkarn5John D. Maclay6Hing Y. Leung7School of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UKWest of Scotland PET Centre, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow G12 0YN, UKSchool of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UKCancer Research UK Beatson Institute, Garscube Estate, Switchback Road, Glasgow G61 1BD, UKWest of Scotland PET Centre, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow G12 0YN, UKDepartment of Respiratory Medicine, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow G4 0SF, UKDepartment of Respiratory Medicine, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow G4 0SF, UKSchool of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK<sup>18</sup>F-FDG positron emission tomography with computed tomography (PET/CT) is a standard imaging modality for the nodal staging of non-small cell lung cancer (NSCLC). To improve the accuracy of pre-operative staging, we compare the staging accuracy of mediastinal lymph node (LN) standard uptake values (SUV) with four derived SUV ratios based on the SUV values of primary tumours (TR), the mediastinal blood pool (MR), liver (LR), and nodal size (SR). In 2015–2017, 53 patients (29 women and 24 men, mean age 67.4 years, range 53–87) receiving surgical resection have pre-operative evidence of mediastinal nodal involvement (cN2). Among these, 114 mediastinal nodes are resected and available for correlative PET/CT analysis. cN2 status accuracy is low, with only 32.5% of the cN2 cases confirmed pathologically. Using receiver operating characteristic (ROC) curve analyses, a SUVmax of N2 LN performs well in predicting the presence of N2 disease (AUC, 0.822). Based on the respective selected thresholds for each ROC curve, normalisation of LN SUVmax to that for mediastinum, liver and tumour improved sensitivities of LN SUVmax from 68% to 81.1–89.2% while maintaining acceptable specificity (68–70.1%). In conclusion, normalised SUV ratios (particularly LR) improve current pre-operative staging performance in detecting mediastinal nodal involvement.https://www.mdpi.com/2075-4418/13/7/1209non-small cell lung cancer<sup>18</sup>F-FDG PET/CTlymph nodeSUVmaxstaging |
| spellingShingle | Maha AlRasheedi Sai Han Helene Thygesen Matt Neilson Fraser Hendry Ahmed Alkarn John D. Maclay Hing Y. Leung A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer Diagnostics non-small cell lung cancer <sup>18</sup>F-FDG PET/CT lymph node SUVmax staging |
| title | A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer |
| title_full | A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer |
| title_fullStr | A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer |
| title_full_unstemmed | A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer |
| title_short | A Comparative Evaluation of Mediastinal Nodal SUVmax and Derived Ratios from <sup>18</sup>F-FDG PET/CT Imaging to Predict Nodal Metastases in Non-Small Cell Lung Cancer |
| title_sort | comparative evaluation of mediastinal nodal suvmax and derived ratios from sup 18 sup f fdg pet ct imaging to predict nodal metastases in non small cell lung cancer |
| topic | non-small cell lung cancer <sup>18</sup>F-FDG PET/CT lymph node SUVmax staging |
| url | https://www.mdpi.com/2075-4418/13/7/1209 |
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