 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Doctors usually use scans, such as computed tomography (CT) scans or positron emission tomography (PET) scans, to see whether lung cancer has spread to mediastinal lymph nodes. A computer linked to an x-ray machine creates CT scans. These scans give a series of detailed pictures of body structures. The PET scan is a relatively new test that involves injecting a radioactive substance into a vein. Cancer cells take up and trap the substance more than do normal cells. The PET scan gives pictures of areas of the body that are "lit up" because cells in that area are rapidly trapping the radioactive substance. There are many studies that look at the ability of CT and PET scans to detect the spread of lung cancer to mediastinal lymph nodes.
SUMMARIES FOR PATIENTS
Detecting Spread of Non–Small-Cell Lung Cancer within the Chest
2 December 2003 | Volume 139 Issue 11 | Page I-18
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Test Performance of Positron Emission Tomography and Computed Tomography for Mediastinal Staging in Patients with Non–Small-Cell Lung Cancer. A Meta-Analysis." It is in the 2 December 2003 issue of Annals of Internal Medicine (volume 139, pages 879-892). The authors are M.K. Gould, W.G. Kuschner, C.E. Rydzak, C.C. Maclean, A.N. Demas, H. Shigemitsu, J.K. Chan, and D.K. Owens.
What is the problem and what is known about it so far?
In the United States, lung cancer is the second most common cancer in both men and women. The most common type of lung cancer is non–small-cell lung cancer. Lung cancer occurs when abnormal cells in the lung divide without control. Sometimes the cancer cells invade nearby tissue and spread through the blood and lymph system to other parts of the body. Some of the first places that lung cancer cells invade are lymph nodes in the area between the lungs (mediastinum).
Why did the researchers do this particular study?
To compare the accuracy of CT and PET scans for detecting spread of non–small-cell lung cancer to mediastinal lymph nodes.
Who was studied?
More than 2500 patients who had participated in 39 different studies.
How was the study done?
Rather than doing a new study, researchers looked at past studies that assessed the accuracy of PET or compared the accuracy of PET with CT for diagnosing spread of cancer to lymph nodes. All patients in the studies had non–small-cell lung cancer. Most patients had biopsies to definitively diagnose spread of cancer to mediastinal lymph nodes. The researchers summarized data from the different studies to see whether CT or PET was better in detecting nodes that did and did not show cancer.
What did the researchers find?
Positron emission tomography was more accurate than CT for identifying cancer spread to lymph nodes. Also, both true-positive and false-positive PET findings were more common in people with enlarged lymph nodes than in people with normal-sized lymph nodes.
What were the limitations of the study?
The study only assessed the ability of PET and CT to detect spread of cancer to mediastinal lymph nodes. Because PET and CT sometimes find spread of cancer in other parts or structures of the body, all of the potential benefits of the 2 tests weren't studied.
What are the implications of the study?
Positron emission tomography is more accurate than CT for mediastinal staging of non–small-cell lung cancer. Because PET has more false-positive findings in patients with enlarged nodes, positive findings need biopsy confirmation.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  D. Uesaka, Y. Demura, T. Ishizaki, S. Ameshima, I. Miyamori, M. Sasaki, Y. Fujibayashi, and H. Okazawa Evaluation of Dual-Time-Point 18F-FDG PET for Staging in Patients with Lung Cancer J. Nucl. Med., October 1, 2008; 49(10): 1606 - 1612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Karam, S. Roberts-Klein, N. Shet, J. Chang, and P. Feustel Bilateral Hilar Foci on 18F-FDG PET Scan in Patients Without Lung Cancer: Variables Associated with Benign and Malignant Etiology J. Nucl. Med., September 1, 2008; 49(9): 1429 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Hishida, J Yoshida, M Nishimura, Y Nishiwaki, and K Nagai Problems in the current diagnostic standards of clinical N1 non-small cell lung cancer Thorax, June 1, 2008; 63(6): 526 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Nomori, T. Mori, K. Ikeda, K. Kawanaka, S. Shiraishi, K. Katahira, and Y. Yamashita Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of non-small cell lung cancer with fewer false-positive results. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 816 - 822. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Marra, L. Hillejan, S. Fechner, and G. Stamatis Remediastinoscopy in restaging of lung cancer after induction therapy. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 843 - 849. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. J. F. Herth, R. Eberhardt, M. Krasnik, and A. Ernst Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Lymph Nodes in the Radiologically and Positron Emission Tomography-Normal Mediastinum in Patients With Lung Cancer Chest, April 1, 2008; 133(4): 887 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Fletcher, B. Djulbegovic, H. P. Soares, B. A. Siegel, V. J. Lowe, G. H. Lyman, R. E. Coleman, R. Wahl, J. C. Paschold, N. Avril, et al. Recommendations on the Use of 18F-FDG PET in Oncology J. Nucl. Med., March 1, 2008; 49(3): 480 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Tournoy, F. De Ryck, L. R. Vanwalleghem, F. Vermassen, M. Praet, J. G. Aerts, G. Van Maele, and J. P. van Meerbeeck Endoscopic Ultrasound Reduces Surgical Mediastinal Staging in Lung Cancer: A Randomized Trial Am. J. Respir. Crit. Care Med., March 1, 2008; 177(5): 531 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Melek, M. Z. Gunluoglu, A. Demir, H. Akin, A. Olcmen, and S. I. Dincer Role of positron emission tomography in mediastinal lymphatic staging of non-small cell lung cancer Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 294 - 299. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Vincent, E. El-Bayoumi, B. Hoffman, P. Doelken, J. DeRosimo, C. Reed, and G. A. Silvestri Real-Time Endobronchial Ultrasound-Guided Transbronchial Lymph Node Aspiration Ann. Thorac. Surg., January 1, 2008; 85(1): 224 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. C. Ung, D. E. Maziak, J. A. Vanderveen, C. A. Smith, K. Gulenchyn, C. Lacchetti, W. K. Evans, and Lung Cancer Disease Site Group of Cancer Care Onta 18Fluorodeoxyglucose Positron Emission Tomography in the Diagnosis and Staging of Lung Cancer: A Systematic Review J Natl Cancer Inst, December 5, 2007; 99(23): 1753 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nakajima, K. Yasufuku, A. Iyoda, S. Yoshida, M. Suzuki, Y. Sekine, K. Shibuya, K. Hiroshima, Y. Nakatani, and T. Fujisawa The evaluation of lymph node metastasis by endobronchial ultrasound-guided transbronchial needle aspiration: Crucial for selection of surgical candidates with metastatic lung tumors. J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1485 - 1490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Hellwig, T. P. Graeter, D. Ukena, A. Groeschel, G. W. Sybrecht, H.-J. Schaefers, and C.-M. Kirsch 18F-FDG PET for Mediastinal Staging of Lung Cancer: Which SUV Threshold Makes Sense? J. Nucl. Med., November 1, 2007; 48(11): 1761 - 1766. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kaira, N. Oriuchi, Y. Otani, K. Shimizu, S. Tanaka, H. Imai, N. Yanagitani, N. Sunaga, T. Hisada, T. Ishizuka, et al. Fluorine-18-{alpha}-Methyltyrosine Positron Emission Tomography for Diagnosis and Staging of Lung Cancer: A Clinicopathologic Study Clin. Cancer Res., November 1, 2007; 13(21): 6369 - 6378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Silvestri, M. K. Gould, M. L. Margolis, L. T. Tanoue, D. McCrory, E. Toloza, and F. Detterbeck Noninvasive Staging of Non-small Cell Lung Cancer: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 178S - 201S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C. Detterbeck, M. A. Jantz, M. Wallace, J. Vansteenkiste, and G. A. Silvestri Invasive Mediastinal Staging of Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 202S - 220S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C Detterbeck Evolution and science, progress and change Thorax, August 1, 2007; 62(8): 654 - 655. [Full Text] [PDF]
|
|
|
|
|
|
K G Tournoy, S Maddens, R Gosselin, G Van Maele, J P van Meerbeeck, and A Kelles Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study Thorax, August 1, 2007; 62(8): 696 - 701. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Vesselle, J. D. Freeman, L. Wiens, J. Stern, H. Q. Nguyen, S. E. Hawes, P. Bastian, A. Salskov, E. Vallieres, and D. E. Wood Fluorodeoxyglucose Uptake of Primary Non-Small Cell Lung Cancer at Positron Emission Tomography: New Contrary Data on Prognostic Role Clin. Cancer Res., June 1, 2007; 13(11): 3255 - 3263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-C. Lee, C.-T. Wu, S.-W. Kuo, Y.-T. Tseng, and Y.-L. Chang Significance of Extranodal Extension of Regional Lymph Nodes in Surgically Resected Non-small Cell Lung Cancer Chest, April 1, 2007; 131(4): 993 - 999. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kaira, N. Oriuchi, Y. Otani, N. Yanagitani, N. Sunaga, T. Hisada, T. Ishizuka, K. Endo, and M. Mori Diagnostic Usefulness of Fluorine-18-{alpha}-Methyltyrosine Positron Emission Tomography in Combination With 18F-Fluorodeoxyglucose in Sarcoidosis Patients Chest, April 1, 2007; 131(4): 1019 - 1027. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Micames, D. C. McCrory, D. A. Pavey, P. S. Jowell, and F. G. Gress Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Non-small Cell Lung Cancer Staging: A Systematic Review and Metaanalysis Chest, February 1, 2007; 131(2): 539 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Tomimaru, M. Higashiyama, J. Okami, K. Oda, K. Takami, K. Kodama, and Y. Tsukamoto Surgical Results of Lung Cancer with Sarcoid Reaction in Regional Lymph Nodes Jpn. J. Clin. Oncol., February 1, 2007; 37(2): 90 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A Yi, K. S. Lee, B.-T. Kim, S. S. Shim, M. J. Chung, Y. M. Sung, and S. Y. Jeong Efficacy of Helical Dynamic CT Versus Integrated PET/CT for Detection of Mediastinal Nodal Metastasis in Non-Small Cell Lung Cancer Am. J. Roentgenol., February 1, 2007; 188(2): 318 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Lauer, S. C. Murthy, E. H. Blackstone, I. C. Okereke, and T. W. Rice [18F]Fluorodeoxyglucose Uptake by Positron Emission Tomography for Diagnosis of Suspected Lung Cancer: Impact of Verification Bias Arch Intern Med, January 22, 2007; 167(2): 161 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Gregoire, K. Haustermans, X. Geets, S. Roels, and M. Lonneux PET-Based Treatment Planning in Radiotherapy: A New Standard? J. Nucl. Med., January 1, 2007; 48(1_suppl): 68S - 77S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Biehl, F.-M. Kong, F. Dehdashti, J.-Y. Jin, S. Mutic, I. El Naqa, B. A. Siegel, and J. D. Bradley 18F-FDG PET Definition of Gross Tumor Volume for Radiotherapy of Non-Small Cell Lung Cancer: Is a Single Standardized Uptake Value Threshold Approach Appropriate? J. Nucl. Med., November 1, 2006; 47(11): 1808 - 1812. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.-T. Kim, K. S. Lee, S. S. Shim, J. Y. Choi, O J. Kwon, H. Kim, Y. M. Shim, J. Kim, and S. Kim Stage T1 Non-Small Cell Lung Cancer: Preoperative Mediastinal Nodal Staging with Integrated FDG PET/CT--A Prospective Study Radiology, November 1, 2006; 241(2): 501 - 509. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yasufuku, T. Nakajima, K. Motoori, Y. Sekine, K. Shibuya, K. Hiroshima, and T. Fujisawa Comparison of Endobronchial Ultrasound, Positron Emission Tomography, and CT for Lymph Node Staging of Lung Cancer. Chest, September 1, 2006; 130(3): 710 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. De Leyn, S. Stroobants, W. De Wever, T. Lerut, W. Coosemans, G. Decker, P. Nafteux, D. Van Raemdonck, L. Mortelmans, K. Nackaerts, et al. Prospective Comparative Study of Integrated Positron Emission Tomography-Computed Tomography Scan Compared With Remediastinoscopy in the Assessment of Residual Mediastinal Lymph Node Disease After Induction Chemotherapy for Mediastinoscopy-Proven Stage IIIA-N2 Non-Small-Cell Lung Cancer: A Leuven Lung Cancer Group Study J. Clin. Oncol., July 20, 2006; 24(21): 3333 - 3339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. F. Meyers, F. Haddad, B. A. Siegel, J. B. Zoole, R. J. Battafarano, N. Veeramachaneni, J. D. Cooper, and G. A. Patterson Cost-effectiveness of routine mediastinoscopy in computed tomography- and positron emission tomography-screened patients with stage I lung cancer J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 822 - 829. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. de Langen, P. Raijmakers, I. Riphagen, M. A. Paul, and O. S. Hoekstra The size of mediastinal lymph nodes and its relation with metastatic involvement: a meta-analysis Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 26 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Pottgen, S. Levegrun, D. Theegarten, S. Marnitz, S. Grehl, R. Pink, W. Eberhardt, G. Stamatis, T. Gauler, G. Antoch, et al. Value of 18F-Fluoro-2-Deoxy-D-Glucose-Positron Emission Tomography/Computed Tomography in Non-Small-Cell Lung Cancer for Prediction of Pathologic Response and Times to Relapse after Neoadjuvant Chemoradiotherapy Clin. Cancer Res., January 1, 2006; 12(1): 97 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. W. Hendrickx, C. M.L. van Herpen, J. J. Bonenkamp, J. Bulten, and W. J.G. Oyen Positive Positron Emission Tomography Scan in Sarcoidosis and Two Challenging Cases of Metastatic Cancer: CASE 1. Mediastinal Sarcoidosis in a Melanoma Patient Treated With Interferon J. Clin. Oncol., December 1, 2005; 23(34): 8906 - 8907. [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Chen and F. Dehdashti Advances in Positron Emission Tomographic Imaging of Lung Cancer Proceedings of the ATS, December 1, 2005; 2(6): 541 - 544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Annema, M. I. Versteegh, M. Veselic, P. Voigt, and K. F. Rabe Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Diagnosis and Staging of Lung Cancer and Its Impact on Surgical Staging J. Clin. Oncol., November 20, 2005; 23(33): 8357 - 8361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Pozo-Rodriguez, J. L. Martin de Nicolas, M. A. Sanchez-Nistal, A. Maldonado, S. Garcia de Barajas, R. Calero-Garcia, M. A. Pozo, P. Martin-Escribano, I. Martin-Garcia, R. Garcia-Lujan, et al. Accuracy of Helical Computed Tomography and [18F] Fluorodeoxyglucose Positron Emission Tomography for Identifying Lymph Node Mediastinal Metastases in Potentially Resectable Non-Small-Cell Lung Cancer J. Clin. Oncol., November 20, 2005; 23(33): 8348 - 8356. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J-E C Holty, W G Kuschner, and M K Gould Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis Thorax, November 1, 2005; 60(11): 949 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Acker and S. C. Burrell Utility of 18F-FDG PET in Evaluating Cancers of Lung J. Nucl. Med. Technol., June 1, 2005; 33(2): 69 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C.A. van Kouwen, F. M. Nagengast, J. B.M.J. Jansen, W. J.G. Oyen, and J. P.H. Drenth 2-(18F)-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Detects Clinical Relevant Adenomas of the Colon: A Prospective Study J. Clin. Oncol., June 1, 2005; 23(16): 3713 - 3717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Kumaran, R E Benamore, R Vaidhyanath, S Muller, C J Richards, M D Peake, and J J Entwisle Ultrasound guided cytological aspiration of supraclavicular lymph nodes in patients with suspected lung cancer Thorax, March 1, 2005; 60(3): 229 - 233. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. B. Karassa, M. I. Matsagas, W. A. Schmidt, and J. P.A. Ioannidis Meta-Analysis: Test Performance of Ultrasonography for Giant-Cell Arteritis Ann Intern Med, March 1, 2005; 142(5): 359 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Higashi, K. Ito, Y. Hiramatsu, T. Ishikawa, T. Sakuma, I. Matsunari, G. Kuga, K. Miura, T. Higuchi, H. Tonami, et al. 18F-FDG Uptake by Primary Tumor as a Predictor of Intratumoral Lymphatic Vessel Invasion and Lymph Node Involvement in Non-Small Cell Lung Cancer: Analysis of a Multicenter Study J. Nucl. Med., February 1, 2005; 46(2): 267 - 273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Schrevens, N. Lorent, C. Dooms, and J. Vansteenkiste The Role of PET Scan in Diagnosis, Staging, and Management of Non-Small Cell Lung Cancer Oncologist, November 1, 2004; 9(6): 633 - 643. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L N Gomersall and S Olson Imaging in lung cancer Imaging, October 1, 2004; 16(1): 1 - 9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C M Richardson and M D Peake Endoscopic (oesophageal) ultrasound guided fine needle aspiration (EUS-FNA) Thorax, July 1, 2004; 59(7): 546 - 547. [Full Text]
|
|
|
|
|
|
F. C. Detterbeck, S. Falen, M. P. Rivera, J. S. Halle, and M. A. Socinski Seeking a Home for a PET, Part 2: Defining the Appropriate Place for Positron Emission Tomography Imaging in the Staging of Patients With Suspected Lung Cancer Chest, June 1, 2004; 125(6): 2300 - 2308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. C. Jacobson, M. K. Gould, G. A. Silvestri, F. Detterbeck, A. Papagiannis, A. Buyukcelik, B. Yalcin, G. Utkan, A. Spira, and D. S. Ettinger Multidisciplinary Management of Lung Cancer N. Engl. J. Med., May 6, 2004; 350(19): 2008 - 2010. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Deyo and J. J. Jarvik New Diagnostic Tests: Breakthrough Approaches or Expensive Add-ons? Ann Intern Med, December 2, 2003; 139(11): 950 - 951. [Full Text] [PDF]
|
|
Article
