Author of

• 14612

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  P2.06 - Poster Session/ Screening and Early Detection (ID 219)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14637

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    P2.06-025 - New PET/CT Criterion for Nodal Staging in Lung Cancer: Area of SUV ≥ 2.5 / Lymph Node Area (ID 61)

    09:30 - 09:30  |  Author(s): S. Motoyama
    • Abstract
    • Slides

    Background:
    Surgical resection is the accepted standard of care for patients with non-small cell lung cancer (NSCLC) at an early stage, patients have a favorable prognosis. Unfortunately, however, only about 25% of NSCLC patients are eligible for surgery, and once the surgical candidates are selected, mediastinal staging is mandatory because up to 50% of these patients have regional metastasis. Accurate nodal staging is crucial for determining optimal treatment strategies and optimizing prognoses. The aim of the present study was to use surgical and histological results to develop a simple noninvasive technique for improving nodal staging using routine preoperative PET/CT in patients presenting with localized and clinically resectable NSCLC.
    
    Methods:
    The institutional review board approved this retrospective study, and written informed consent to perform the initial and follow-up CT studies was obtained from all patients. Preoperative PET/CT findings (n=163 patients with resectable NSCLC) and pathological diagnoses after surgical resection were evaluated. Using PET/CT images, lymph node surface area (SA), the maximum standardized uptake value (SUV~max~), SA of SUV ≥2.5 (Figure) and ≥3.0 were drawn freehand and measured using caliper software. Receiver operating characteristic (ROC) curves were then used to analyze those data. Figure 1
    
    
    
    Results:
    Based on ROC analyses, the cut-off values for SA of SUV ≥2.5, SA of SUV ≥3.0, SUV ≥2.5 SA / node SA ratio and SUV ≥3.0 SA / node SA ratio for diagnosis of lymph node metastasis were 200 mm[2], 30 mm[2], 1.0 and 0.4. When the conventional SUV~max~ ≥2.5 was used for diagnosis, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of nodal staging were 61.1%, 62.2%, 28.9%, 86.4%, 62.0% , respectively. SUV ≥2.5 SA / node SA ≥1.0 had the highest negative predictive value, and when a cut-off value of SUV ≥2.5 SA / node SA ≥1.0 was used for diagnosis, the sensitivity, specificity, PPV, NPV and accuracy were 61.1%, 73.4%, 36.7%, 88.2% and 70.9%, respectively.
    
    Conclusion:
    When diagnosing nodal staging based a lymph node SUV ≥2.5 SA / node SA ratio of ≥1.0, we achieved a higher performance level than was achieved using the conventional of SUV~max~ criterion. Furthermore, determination of this ratio from PET/CT images is a simple noninvasive procedure.
    
    

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