Consideration of serum glucose levels during malignant mediastinal lymph node detection in non-small-cell lung cancer by FDG-PET

Woo Lee Won, Jin Haeng Chung, Sung June Jang, Seon Eo Jae, Yeon Park So, Whan Sung Sook, Young So, June Key Chung, Chul Lee Myung, Eun Kim Sang

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and Objective: Glucose and FDG compete for uptake by cancers. Here, we undertook to improve diagnostic accuracy of FDG-PET for determining mediastinal lymph node (LN) status in NSCLC by considering serum glucose level. Methods: NSCLC patients (n = 70) who underwent curative lung resection and mediastinal LN dissection within 1 month of FDG-PET were enrolled. MaxSUV was calculated using lean body weight and used to determine a new parameter (maxSUV x serum glucose level; maxSUV-GL). Histopathologic LN results were compared with maxSUV and maxSUV-GL values. Results: Of 71 LN stations whose FDG uptake could be measured, 21 were malignant and 50 benign. MaxSUV of LN had AUC of 0.729 (95% CI: 0.610-0.827) by ROC analysis with sensitivity of 47.6% (10/21), specificity of 94.0% (47/50), and a cutoff value of 3.3. Using maxSUV-GL the corresponding values were; AUC 0.825 (95% CI: 0.716-0.905) and sensitivity 76.2% (16/21), with a cutoff value of 290.4, which represented a significant improvement (P < 0.01) without compromising specificity 88.0% (44/50) (P > 0.05). The exclusion of neo-adjuvant chemotherapeutic and diabetic patients resulted in a similar improvement in diagnostic accuracy. Conclusion: By considering serum glucose level during FDG-PET using the new parameter maxSUV-GL, sensitivity for malignant mediastinal LN detection is improved.

Original languageEnglish
Pages (from-to)607-613
Number of pages7
JournalJournal of Surgical Oncology
Volume94
Issue number7
DOIs
Publication statusPublished - 2006 Dec 1
Externally publishedYes

Keywords

  • Lung cancer
  • Metabolism
  • SUV

ASJC Scopus subject areas

  • Surgery
  • Oncology

Fingerprint Dive into the research topics of 'Consideration of serum glucose levels during malignant mediastinal lymph node detection in non-small-cell lung cancer by FDG-PET'. Together they form a unique fingerprint.

  • Cite this

    Won, W. L., Chung, J. H., Jang, S. J., Jae, S. E., So, Y. P., Sook, W. S., So, Y., Chung, J. K., Myung, C. L., & Sang, E. K. (2006). Consideration of serum glucose levels during malignant mediastinal lymph node detection in non-small-cell lung cancer by FDG-PET. Journal of Surgical Oncology, 94(7), 607-613. https://doi.org/10.1002/jso.20624