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KMID : 1103720100620030235
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Journal of the Korean Society of Radiology
2010 Volume.62 No. 3 p.235 ~ p.243
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Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the 18F-FDG Positron Emission Tomography CT Correlation
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Yoon Soo-Kyung
Jung Jung-Im
Park Seog-Hee
Park Mi-Jung
Park Hyun-Jin
Ahn Myeong-Im
Park Jae-Kil
Yoo Ie-Ryung
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Abstract
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Purpose: To investigate the size criteria of multidetector computed tomography (MDCT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT).
Materials and Methods: Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs.
Results: The size of metastatic LNs (9.35 3.41 mm) was significantly larger than that of benign LNs (5.74 1.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT.
Conclusion: Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region.
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KEYWORD
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Esophageal Neoplasms, Tomography, X-Ray Computed, Positron-Emission Tomography, Lymph nodes
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