NDLI: PET-CT has low specificity for mediastinal staging of non-small-cell lung cancer in an endemic area for tuberculosis: a diagnostic test study (LACOG 0114)

Content Provider	Springer Nature : BioMed Central
Author	Werutsky, Gustavo Hochhegger, Bruno Lopes de Figueiredo Pinto, José Antônio Martínez-Mesa, Jeovany Zanini, Mara Lise Berdichevski, Eduardo Herz Vilas, Eduardo da Silva, Vinícius Duval Tsukazan, Maria Teresa Ruiz Vieira, Arthur Fritscher, Leandro Genehr Hartmann, Louise Alba, Marcos Sartori, Guilherme Matushita, Cristina Bortolotto, Vanessa do Amaral, Rayssa Ruszkowski Junior, Luís Carlos Anflor Zaffaroni, Facundo Barrios, Carlos H. Debiasi, Márcio Frietscher, Carlos Cezar
Abstract	Background The present study aims to assess the performance of 18F-FDG PET-CT on mediastinal staging of non-small cell lung cancer (NSCLC) in a location with endemic granulomatous infectious disease. Methods Diagnostic test study including patients aged 18 years or older with operable stage I-III NSCLC and indication for a mediastinal lymph node biopsy. All patients underwent a 18F-FDG PET-scan before invasive mediastinal staging, either through mediastinoscopy or thoracotomy, which was considered the gold-standard. Surgeons and pathologists were blinded for scan results. Primary endpoint was to evaluate sensitivity, specificity and positive and negative predictive values of PET-CT with images acquired in the 1st hour of the exam protocol, using predefined cutoffs of maximal SUV, on per-patient basis. Results Overall, 85 patients with operable NSCLC underwent PET-CT scan followed by invasive mediastinal staging. Mean age was 65 years, 49 patients were male and 68 were white. One patient presented with active tuberculosis and none had HIV infection. Using any SUV_max > 0 as qualitative criteria for positivity, sensitivity and specificity were 0.87 and 0.45, respectively. Nevertheless, even when the highest SUV cut-off was used (SUV_max ≥5), specificity remained low (0.79), with an estimated positive predictive value of 54%. Conclusions Our findings are in line with the most recent publications and guidelines, which recommend that PET-CT must not be solely used as a tool to mediastinal staging, even in a region with high burden of tuberculosis. Trial registration The LACOG 0114 study was registered at ClinicalTrials.gov , before study initiation, under identifier NCT02664792.
Related Links	https://bmccancer.biomedcentral.com/counter/pdf/10.1186/s12885-018-5233-5.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14712407
DOI	10.1186/s12885-018-5233-5
Journal	BMC Cancer
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2019-01-03
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Surgical Oncology Health Promotion and Disease Prevention Biomedicine Medicine Public Health Non-small cell lung cancer PET-CT Mediastinal staging Granulomatous infectious diseases Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology Genetics
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	3.8/2023

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