Küçük Hücreli Dışı Akciğer Kanseri Evrelemesinde Bölgesel Nod Tutulumunun F-18 FDG PET/BT ile Değerlendirilmesi

Yıl 2025, Cilt: 12 Sayı: 1, 55 - 62, 26.03.2025

Mutlay Keskin , Haydar Aslan

https://doi.org/10.34087/cbusbed.1543404

Öz

Evaluation of Regional Node Involvement in The Staging of Non-small Cell Lung Cancer with F-18 FDG PET/CT
Küçük Hücreli Dışı Akciğer Kanseri Evrelemesinde Bölgesel Nod Tutulumunun F-18 FDG PET/BT ile Değerlendirilmesi
Mutlay KESKİN1*, Haydar ASLAN1
1Mersin Şehir Eğitim ve Araştırma Hastanesi Nükleer Tıp Kliniği Mersin, Türkiye
e-mail: [e-mail], [e-mail],
ORCID: 0000-0003-2528-8648
ORCID: 0009-0001-0232-6712
*Sorumlu Yazar/Corresponding Author: Mutlay Keskin
Gönderim Tarihi / Received:
Kabul Tarihi / Accepted:
DOI:

Öz
Giriş ve Amaç: PET/BT’de küçük hücreli dışı akciğer kanserinin (KHDAK) nodal evrelemesi için mediastinal kan havuzu (MKH) aktivite eşik değerinin tanısal performansını değerlendirmek ve bölgesel nod tutulumunu değerlendirmede F-18 FDG-PET/BT'nin tanısal performansını artırabilecek değişkenleri incelemektir.
Gereç ve Yöntemler: Endobronşiyal ultrason eşliğinde transbronşiyal iğne aspirasyonu ve F-18 FDG-PET/BT uygulanan KHDAK tanılı hastalar çalışmaya dahil edildi. Lenf nodu istasyonu ve lenf nodu evrelemesinin analizi, MKH eşik değeri ile diğer beş PET/BT parametresi histopatolojik sonuçlarla karşılaştırıldı.
Bulgular: Çalışmaya 88 hasta dâhil edilmiş olup 250 lenf nodu istasyonundan patolojik örneklem yapıldı. PET/BT’de lenf nodu aktivitesinin MKH'dan yüksek olması %95.3 duyarlılık, %36.1 özgüllük, %33.1 pozitif öngörü değeri, %96.2 negatif öngörü değeri göstermiştir. İncelenen diğer beş PET/BT parametresinden nodal SUVmaks değeri ve lenf nodu/MKH SUVmaks oranı en tanısal parametrelerdi. Nodal SUVmaks için 3.8 eşik değeri %90.2 duyarlılık, %61.7 özgüllüközgüllük; lenf nodu/MKH SUVmaks oranı için 1.8 eşik değeri %90.1 duyarlılık, %60.5 özgüllük değeri göstermiştir.
Sonuç: Nodal evrelemede MKH eşik değeri ile karşılaştırıldığında daha yüksek lenf nodu/MKH SUVmaks oranı eşik değeri ve diğer PET/BT değişkenlerinin kullanılması PET/BT'nin tanısal değerini artırabilir.
Anahtar Kelimeler: Küçük hücreli dışı akciğer kanseri, PET/BT, FDG

Abstract
Aim: To evaluate the diagnostic performance of mediastinal blood pool activity(MBP) threshold for nodal staging of non-small cell lung cancer (NSCLC) on PET/CT and to examine the variables that may improve the diagnostic performance of 18F-FDG-PET/CT in evaluating regional lymph node involvement.
Materials and Methods: Patients diagnosed with NSCLC who underwent endobronchial ultrasound guided transbronchial needle aspiration and 18F-FDG-PET/CT were included in the study. Analysis of lymph node station and lymph node staging, MBP threshold value and five other PET/CT parameters compared with histopathological results.
Results: Eighty eight patients were included in the study and pathological samples were performed from 250 lymph node stations. The higher lymph node activity in PET/CT than MBP showed a sensitivity of 95.3%,a specificity of 36.1%,a positive prediction value of 33.1%, a negative prediction value of 96.2%.From the other five PET/CT parameters examined, nodal SUVmax value and lymph node/MBP SUVmax ratio were the most diagnostic parameters. The 3.8 threshold value for nodal SUVmax showed a sensitivity of 90.2%, a specificity of 61.7%,and the 1.8 threshold for lymph node/MBP SUVmax ratio showed a sensitivity of 90.1%, a specificity of 60.5%.
Conclusion: Compared to MBP threshold value in the nodal staging, use of higher lymph node/MBP SUVmax ratio threshold value and other PET/CT variables may increase the diagnostic value of PET/CT.
Keywords: Non-small cell lung cancer, PET/CT, FDG

Anahtar Kelimeler

Küçük hücreli dışı akciğer kanseri, PET/BT, FDG

Proje Numarası

Mersin City Training and Research Hospital, with the decision dated May 10, 2023, and numbered 70.

Evaluation of Regional Node Involvement in The Staging of Non-small Cell Lung Cancer with F-18 FDG PET/CT

Öz

Öz
Giriş ve Amaç: PET/BT’de küçük hücreli dışı akciğer kanserinin (KHDAK) nodal evrelemesi için mediastinal kan havuzu (MKH) aktivite eşik değerinin tanısal performansını değerlendirmek ve bölgesel nod tutulumunu değerlendirmede F-18 FDG-PET/BT'nin tanısal performansını artırabilecek değişkenleri incelemektir.
Gereç ve Yöntemler: Endobronşiyal ultrason eşliğinde transbronşiyal iğne aspirasyonu ve F-18 FDG-PET/BT uygulanan KHDAK tanılı hastalar çalışmaya dahil edildi. Lenf nodu istasyonu ve lenf nodu evrelemesinin analizi, MKH eşik değeri ile diğer beş PET/BT parametresi histopatolojik sonuçlarla karşılaştırıldı.
Bulgular: Çalışmaya 88 hasta dâhil edilmiş olup 250 lenf nodu istasyonundan patolojik örneklem yapıldı. PET/BT’de lenf nodu aktivitesinin MKH'dan yüksek olması %95.3 duyarlılık, %36.1 özgüllük, %33.1 pozitif öngörü değeri, %96.2 negatif öngörü değeri göstermiştir. İncelenen diğer beş PET/BT parametresinden nodal SUVmaks değeri ve lenf nodu/MKH SUVmaks oranı en tanısal parametrelerdi. Nodal SUVmaks için 3.8 eşik değeri %90.2 duyarlılık, %61.7 özgüllüközgüllük; lenf nodu/MKH SUVmaks oranı için 1.8 eşik değeri %90.1 duyarlılık, %60.5 özgüllük değeri göstermiştir.
Sonuç: Nodal evrelemede MKH eşik değeri ile karşılaştırıldığında daha yüksek lenf nodu/MKH SUVmaks oranı eşik değeri ve diğer PET/BT değişkenlerinin kullanılması PET/BT'nin tanısal değerini artırabilir.
Anahtar Kelimeler: Küçük hücreli dışı akciğer kanseri, PET/BT, FDG

Abstract
Aim: To evaluate the diagnostic performance of mediastinal blood pool activity(MBP) threshold for nodal staging of non-small cell lung cancer (NSCLC) on PET/CT and to examine the variables that may improve the diagnostic performance of 18F-FDG-PET/CT in evaluating regional lymph node involvement.
Materials and Methods: Patients diagnosed with NSCLC who underwent endobronchial ultrasound guided transbronchial needle aspiration and 18F-FDG-PET/CT were included in the study. Analysis of lymph node station and lymph node staging, MBP threshold value and five other PET/CT parameters compared with histopathological results.
Results: Eighty eight patients were included in the study and pathological samples were performed from 250 lymph node stations. The higher lymph node activity in PET/CT than MBP showed a sensitivity of 95.3%,a specificity of 36.1%,a positive prediction value of 33.1%, a negative prediction value of 96.2%.From the other five PET/CT parameters examined, nodal SUVmax value and lymph node/MBP SUVmax ratio were the most diagnostic parameters. The 3.8 threshold value for nodal SUVmax showed a sensitivity of 90.2%, a specificity of 61.7%,and the 1.8 threshold for lymph node/MBP SUVmax ratio showed a sensitivity of 90.1%, a specificity of 60.5%.
Conclusion: Compared to MBP threshold value in the nodal staging, use of higher lymph node/MBP SUVmax ratio threshold value and other PET/CT variables may increase the diagnostic value of PET/CT.
Keywords: Non-small cell lung cancer, PET/CT, FDG

Anahtar Kelimeler

Non-small cell lung cancer, PET/CT, FDG

Proje Numarası

Mersin City Training and Research Hospital, with the decision dated May 10, 2023, and numbered 70.

Kaynakça

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