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Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer?  Kemp H Kernstine, MD, PhD, Kelley A McLaughlin,

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Presentation on theme: "Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer?  Kemp H Kernstine, MD, PhD, Kelley A McLaughlin,"— Presentation transcript:

1 Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer? 
Kemp H Kernstine, MD, PhD, Kelley A McLaughlin, RN, Yusuf Menda, MD, Nicholas P Rossi, MD, Daniel J Kahn, MD, David L Bushnell, MD, Michael M Graham, MD, PhD, Carl K Brown, MS, Mark T Madsen, PhD  The Annals of Thoracic Surgery  Volume 73, Issue 2, Pages (February 2002) DOI: /S (01)

2 Fig 1 (A) Computed tomogram and (B) positron emission tomogram (PET) with suspicious parenchymal mass on computed tomographic scan (CT) and PET negative and no PET mediastinal disease. A transverse image of a CT scan and a coronal image of a PET scan in the same patient with a suspicious lung mass. The standard uptake value (SUV) of the 1.5 cm spiculated noncalcified mass (arrow) was zero. There was no fluorodeoxyglucose uptake in the mediastinum. Biopsy of the mediastinal lymph nodes was negative for malignancy. The primary was an adenocarcinoma. From our data and analysis, in patients such as this individual, in which the SUV of the primary lesion is less than 2.5 and the mediastinum is PET negative, mediastinoscopy is unnecessary. The Annals of Thoracic Surgery  , DOI: ( /S (01) )

3 Fig 2 Potential algorithm coordinating the use of positron emission tomography (PET) in the evaluation of patients with non-small cell lung cancer (NSCLC). Performance of tests, inclusive of pulmonary function tests (PFTs), bronchoscopy, bone scan, head computed tomography or magnetic resonance imaging, evaluation of combined diseases or performance status, may be performed at the discretion of the examiner or dependent upon the initial evaluation of the patient. Operable patients with known group or suspect group NSCLC should have a PET scan in addition to the chest computed tomographic scan. Ten percent to 20% (A) will be found to have asymptomatic unrecognized metastases of which half, 5% to 10% (C), will be found to be positive by minimal invasive testing that will warrant no pulmonary surgical resection [10]. The other 10% (D) will need further thoracic surgical evaluation. From this report, an additional 12% (B) will be found not to need mediastinoscopy. Combining (C) and (B), by using PET, it appears that mediastinoscopy will be unnecessary in 15% to 20% of patients. The Annals of Thoracic Surgery  , DOI: ( /S (01) )

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