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Accuracy of F-18 FDG PET/CT for diagnosis of small regional lymph node metastasis in patients with rectal cancer

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Author(s)
원경숙송봉일김해원
Alternative Author(s)
Won, Kyoung SookSong, Bong IlKim, Hae Won
Publication Year
2018
Keyword
F-18 FDGLymph node metastasisMaximum standardized uptake valuePET/CTPartial volume effectRectal cancer
Abstract
BACKGROUND:

The low sensitivity of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of metastatic lymph nodes (LNs) is mainly due to the partial volume effect in patients with rectal cancer. This retrospective study evaluated the diagnostic accuracy of F-18 FDG PET/CT with optimal cut-off values of the maximum standardized uptake value (SUVmax), according to LN size, for the evaluation of regional LN in rectal cancer patients.

METHODS:

This study included 176 patients with rectal cancer who underwent F-18 FDG PET/CT for initial staging. Patients were classified based on the long-axis diameter of the regional LN on CT images as small (≤ 7 mm; n = 118) and large (> 7 mm; n = 58) LN groups. The optimal cut-off value of SUVmax was determined for each group, using receiver operating characteristic curve analysis. Areas under the curve (AUC) were compared by C-statistics using two methods: the cut-off value of SUVmax optimized according to LN size, and a fixed SUVmax cut-off value of 2.5.

RESULTS:

The optimal cut-off values of SUVmax for the small and large LN groups were 1.1, and 2.1, respectively. The sensitivity, specificity, and accuracy of F-18 FDG PET/CT using the optimal cut-off values were 90.6, 70.9, and 76.3% in the small LN group, and 68.6, 78.3, and 72.4% in the large LN group. The sensitivity, specificity, and accuracy of F-18 FDG PET/CT using the fixed cut-off value were 18.8, 100, and 78.0% in the small LN group, and 51.4, 87.0, and 65.5% in the large LN group. The AUC was significantly higher using the optimal cut-off values than the fixed cut-off value (0.808 vs. 0.594, p = 0.005) in the small LN group, but not in the large LN group (0.734 vs. 0.692, p = 0.429).

CONCLUSIONS:

Application of the lower cut-off value of SUVmax improves the diagnostic performance of F-18 FDG PET/CT for the evaluation of small regional LNs in patients with rectal cancer.
Department
Dept. of Nuclear Medicine (핵의학)
Publisher
School of Medicine (의과대학)
Citation
Cancer Imaging, Vol.18(1) : 32-32, 2018
Type
Article
ISSN
1740-5025
DOI
10.1186/s40644-018-0165-5
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41053
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