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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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Affiliated Author(s)
원경숙송봉일김해원
Alternative Author(s)
Won, Kyoung SookSong, Bong IlKim, Hae Won
Journal Title
Cancer Imaging
ISSN
1740-5025
Issued Date
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
Sung Uk Bae et al. (2018). Accuracy of F-18 FDG PET/CT for diagnosis of small regional lymph node metastasis in patients with rectal cancer. Cancer Imaging, 18(1), 32–32. doi: 10.1186/s40644-018-0165-5
Type
Article
ISSN
1740-5025
DOI
10.1186/s40644-018-0165-5
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41053
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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