Wang H, Li QK, Auster M, Gong G. PET and CT features differentiating infectious/inflammatory from malignant mediastinal lymphadenopathy: A correlated study with endobronchial ultrasound-guided transbronchial needle aspiration.
ACTA ACUST UNITED AC 2018;
5:7-13. [PMID:
31692939 PMCID:
PMC6831101 DOI:
10.1016/j.jrid.2018.01.002]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] [Imported: 08/29/2023]
Abstract
Purpose:
To explore the advantages of differentiating inflammatory from malignant thoracic lymph nodes by integrating their features on positron emission tomography (PET) and computed tomography (CT).
Material and method:
Following institutional review board approval, PET and CT parameters of thoracic lymph nodes were examined based on their pathologic diagnosis via endobronchial ultrasound-guided transbronchial needle aspiration. The standardized uptake value (SUV) of PET and CT findings of the long- and short-axis diameters, axial short to long diameter ratios (S/L), and measured nodal CT values of the lymph nodes were compared and analyzed statistically.
Results:
A total of 124 lymph nodes from 70 patients were studied. The inflammatory and malignant lymph nodes differed significantly in their SUV (P = 0.008), short-axis diameters (SAD, p < 0.001), long-axis diameters (LAD, p = 0.002) and S/L ratios (p < 0.001). They did not differ significantly in non-contrast enhanced CT values (p = 0.304). The sensitivities, specificities, positive predictive values, negative predictive values, diagnostic accuracies and diagnostic odds ratios (DOR) were: 1) elevated SUV alone - 95.31% (61/64), 20% (12/60), 55.96% (61/109), 80% (12/15), 58.87% (73/124), and 5; 2) combined SUV + SAD - 89.06%, 53.33%, 67.06%, 82.05%, 71.77%, and 9.31; 3) combined SUV + S/L ratio - 87.5%, 93.33%, 93.33%, 87.5%, 90.32%, and 98, respectively.
Conclusion:
Increased SUV, SAD, LAD, and S/L ratio are accurate PET/CT parameters to characterize inflammatory or malignant lymph nodes. SUV has high sensitivity but low specificity, low positive and negative predictive values, and low DOR. The SUV + SAD and SUV + S/L ratios have higher specificity, positive and negative predictive values, diagnostic accuracy and DOR.
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