NONSMALL CELL LUNG-CANCER - NODAL STAGING WITH FDG PET VERSUS CT WITHCORRELATIVE LYMPH-NODE MAPPING AND SAMPLING

PURPOSE: To prospectively compare the accuracy of positron emission to mography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) with that of computed tomography (CT) in the nodal staging of non-small ce ll lung cancer. MATERIALS AND METHODS: PET and contrast material-enhan ced CT were performed in 47 patients suspected of having or with newly diagnosed non-small cell lung cancer. Each imaging study was evaluate d separately, and nodal stations were localized according to the Ameri can Thoracic Society mapping system. Extensive lymph node sampling (59 9 nodes from 191 nodal stations) of the ipsi- and contralateral trache obronchial and mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Imaging findings were correlated with histopa thologic staging results. RESULTS: The sensitivity of PET and CT was 8 9% and 57%, respectively, for the staging of N2 or N3 disease in media stinal nodes; specificity was 99% and 94%, respectively; positive pred ictive value was 96% and 76%, respectively; negative predictive value was 97% and 87%, respectively; and accuracy was 96% and 85%, respectiv ely. In assigning the correct N stage, PET was correct in 96% and CT i n 79% of cases. CONCLUSION: PET with FDG appears to be superior to CT for nodal staging of non-small cell lung cancer.