Identification of false-negative and false-positive diagnoses of lymph node metastases in non-small cell lung cancer patients staged by integrated 18F-fluorodeoxyglucose-positron emission tomography/computed tomography: A retrospective cohort study

Kaoru Kaseda, Ken ichi Watanabe, Keisuke Asakura, Akio Kazama, Yukihiko Ozawa

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the diagnostic accuracy of integrated 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non-small cell lung cancer (NSCLC), and to investigate potential risk factors for false-negative and false-positive HMLN metastases. Methods: We examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG-PET/CT. Risk factors for false-negative and false-positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG-PET/CT in detecting HMLN metastases were 47.4%, 91.0%, 56.3%, 87.7%, and 82.5%, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor (P = 0.042), adenocarcinoma (P = 0.003), and tumor size (P = 0.017) were risk factors for false-negative HMLN metastases, and history of lung disease (P = 0.006) and tumor location (central; P = 0.025) were risk factors for false-positive HMLN metastases. Conclusions: The present study identified risk factors for false-negative and false-positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG-PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration.

Original languageEnglish
Pages (from-to)473-480
Number of pages8
JournalThoracic Cancer
Volume7
Issue number4
DOIs
Publication statusPublished - 2016 Jul 1
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Non-Small Cell Lung Carcinoma
Cohort Studies
Retrospective Studies
Lymph Nodes
Neoplasm Metastasis
Multivariate Analysis
Mediastinoscopy
Neoplasms
Positron Emission Tomography Computed Tomography
Lung Diseases
Needles
Adenocarcinoma
Sensitivity and Specificity

Keywords

  • Lymph node staging
  • non-small cell lung cancer
  • positron emission tomography

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

@article{da15d234301b41ccad40132cce1616b0,
title = "Identification of false-negative and false-positive diagnoses of lymph node metastases in non-small cell lung cancer patients staged by integrated 18F-fluorodeoxyglucose-positron emission tomography/computed tomography: A retrospective cohort study",
abstract = "Background: The aim of this study was to evaluate the diagnostic accuracy of integrated 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non-small cell lung cancer (NSCLC), and to investigate potential risk factors for false-negative and false-positive HMLN metastases. Methods: We examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG-PET/CT. Risk factors for false-negative and false-positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG-PET/CT in detecting HMLN metastases were 47.4{\%}, 91.0{\%}, 56.3{\%}, 87.7{\%}, and 82.5{\%}, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor (P = 0.042), adenocarcinoma (P = 0.003), and tumor size (P = 0.017) were risk factors for false-negative HMLN metastases, and history of lung disease (P = 0.006) and tumor location (central; P = 0.025) were risk factors for false-positive HMLN metastases. Conclusions: The present study identified risk factors for false-negative and false-positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG-PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration.",
keywords = "Lymph node staging, non-small cell lung cancer, positron emission tomography",
author = "Kaoru Kaseda and Watanabe, {Ken ichi} and Keisuke Asakura and Akio Kazama and Yukihiko Ozawa",
year = "2016",
month = "7",
day = "1",
doi = "10.1111/1759-7714.12358",
language = "English",
volume = "7",
pages = "473--480",
journal = "Thoracic Cancer",
issn = "1759-7706",
publisher = "Blackwell Publishing Asia Pty Ltd",
number = "4",

}

TY - JOUR

T1 - Identification of false-negative and false-positive diagnoses of lymph node metastases in non-small cell lung cancer patients staged by integrated 18F-fluorodeoxyglucose-positron emission tomography/computed tomography

T2 - A retrospective cohort study

AU - Kaseda, Kaoru

AU - Watanabe, Ken ichi

AU - Asakura, Keisuke

AU - Kazama, Akio

AU - Ozawa, Yukihiko

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: The aim of this study was to evaluate the diagnostic accuracy of integrated 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non-small cell lung cancer (NSCLC), and to investigate potential risk factors for false-negative and false-positive HMLN metastases. Methods: We examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG-PET/CT. Risk factors for false-negative and false-positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG-PET/CT in detecting HMLN metastases were 47.4%, 91.0%, 56.3%, 87.7%, and 82.5%, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor (P = 0.042), adenocarcinoma (P = 0.003), and tumor size (P = 0.017) were risk factors for false-negative HMLN metastases, and history of lung disease (P = 0.006) and tumor location (central; P = 0.025) were risk factors for false-positive HMLN metastases. Conclusions: The present study identified risk factors for false-negative and false-positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG-PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration.

AB - Background: The aim of this study was to evaluate the diagnostic accuracy of integrated 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non-small cell lung cancer (NSCLC), and to investigate potential risk factors for false-negative and false-positive HMLN metastases. Methods: We examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG-PET/CT. Risk factors for false-negative and false-positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG-PET/CT in detecting HMLN metastases were 47.4%, 91.0%, 56.3%, 87.7%, and 82.5%, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor (P = 0.042), adenocarcinoma (P = 0.003), and tumor size (P = 0.017) were risk factors for false-negative HMLN metastases, and history of lung disease (P = 0.006) and tumor location (central; P = 0.025) were risk factors for false-positive HMLN metastases. Conclusions: The present study identified risk factors for false-negative and false-positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG-PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration.

KW - Lymph node staging

KW - non-small cell lung cancer

KW - positron emission tomography

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U2 - 10.1111/1759-7714.12358

DO - 10.1111/1759-7714.12358

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C2 - 27385991

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VL - 7

SP - 473

EP - 480

JO - Thoracic Cancer

JF - Thoracic Cancer

SN - 1759-7706

IS - 4

ER -