A predictive model for lymph node involvement with malignancy on PET/CT in non-small-cell lung cancer Journal Article


Authors: Mattes, M. D.; Weber, W. A.; Foster, A.; Moshchinsky, A. B.; Ahsanuddin, S.; Zhang, Z.; Shi, W.; Rizk, N. P.; Wu, A. J.; Ashamalla, H.; Rimner, A.
Article Title: A predictive model for lymph node involvement with malignancy on PET/CT in non-small-cell lung cancer
Abstract: Introduction: Accurate assessment of lymph node (LN) involvement with malignancy is critical to staging and management of non-smallcell lung cancer. The goal of this retrospective study was to determine the tumor and imaging characteristics independently associated with malignant involvement of LNs visualized on positron emission tomography/computed tomography (PET/CT). Methods: From 2002 to 2011, 172 patients with newly diagnosed non- small-cell lung cancer underwent PET/CT within 31 days before LN biopsy. Among these patients, 504 anatomically defined, pathologyconfirmed LNs were visualized on PET/CT. Logistic regression analysis was used to determine the associations between nodal involvement with malignancy and several clinical and imaging variables, including tumor histology, tumor grade, LN risk category in relation to the primary tumor location, pathologic findings from additional biopsied LNs, interval between PET/CT and biopsy, primary tumor largest dimension, primary tumor standardized uptake value (SUVmax), LN short-Axis dimension, and LN SUVmax. Results: On univariate analysis, adenocarcinoma histology (p = 0.010), high LN risk category (p < 0.001), larger LN short-Axis dimension (p < 0.001), and higher LN SUVmax (p < 0.001) all correlated with nodal involvement. On multivariate analysis, adenocarcinoma histology (p = 0.003), high LN risk category (p = 0.005), and higher LN SUVmax (p < 0.001) correlated with nodal involvement, whereas LN short-Axis dimension was no longer statistically significant (p = 0.180). A nomogram developed for clinical application based on this analysis had excellent concordance between predicted and observed results (concordance index, 0.95). Conclusion: Adenocarcinoma histology, higher LN SUVmax, and higher LN risk category independently correlate with nodal involvement with malignancy and may be used in a model to accurately predict the risk of a node's involvement with malignancy. Copyright © 2015 by the International Association for the Study of Lung Cancer.
Keywords: adult; controlled study; aged; primary tumor; major clinical study; cancer patient; lymph node metastasis; staging; tumor biopsy; retrospective study; lymph node; fluorodeoxyglucose f 18; computer assisted emission tomography; glucose blood level; glucose; pet; cancer scintiscanning; lung biopsy; nomogram; non small cell lung cancer; nsclc; human; priority journal; article
Journal Title: Journal of Thoracic Oncology
Volume: 10
Issue: 8
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2015-08-01
Start Page: 1207
End Page: 1212
Language: English
DOI: 10.1097/jto.0000000000000601
PROVIDER: scopus
PUBMED: 26200276
DOI/URL:
Notes: Export Date: 2 November 2015 -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    428 Zhang
  2. Weiji Shi
    121 Shi
  3. Nabil Rizk
    139 Rizk
  4. Andreas Rimner
    525 Rimner
  5. Abraham Jing-Ching Wu
    401 Wu
  6. Amanda Foster
    64 Foster
  7. Wolfgang Andreas Weber
    173 Weber