HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hiroaki Nomori Takashi Ohtsuka Tsuguo Naruke Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nomori, H. Articles by Uno, K. Search for Related Content PubMed PubMed Citation Articles by Nomori, H. Articles by Uno, K. Related Collections Lung - cancer

J Thorac Cardiovasc Surg 2004;128:396-401
© 2004 The American Association for Thoracic Surgery

General thoracic surgery

Fluorine 18–tagged fluorodeoxyglucose positron emission tomographic scanning to predict lymph node metastasis, invasiveness, or both, in clinical T1 N0 M0 lung adenocarcinoma

^a Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan
^b Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
^c Nishidai Clinic, Tokyo, Japan

Received for publication December 17, 2003; revisions received February 12, 2004; accepted for publication March 22, 2004.

^* Address for reprints: Hiroaki Nomori, MD, PhD, Department of Thoracic Surgery, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan
hnomori{at}qk9.so-net.ne.jp

OBJECTIVE: We sought to predict lymph node metastasis and tumor invasiveness in clinical T1 N0 M0 lung adenocarcinomas, and we measured fluorodeoxyglucose uptake on positron emission tomography.

METHODS: Fluorodeoxyglucose positron emission tomography was performed on 44 patients with adenocarcinomas of 1 to 3 cm in size clinically staged as T1 N0 M0 before major lung resection with lymph node dissection. Fluorodeoxyglucose uptake was evaluated by using the contrast ratio between the tumor and contralateral healthy lung tissue. Lymphatic and vascular invasion within tumors, pleural involvement, and grade of histologic differentiation were examined.

RESULTS: The pathologic tumor stage was T1 N0 M0 in 36 patients, and a more advanced stage was found in 8 patients. Although all 22 adenocarcinomas with a contrast ratio of less than 0.5 in fluorodeoxyglucose uptake were pathologic T1 N0 M0 tumors, 8 (36%) of 22 with a contrast ratio of 0.5 or greater were of a more advanced stage than T1 N0 M0, with the difference being significant (P = .002). Adenocarcinomas with a contrast ratio of less than 0.5 showed less lymphatic and vascular invasion and less pleural involvement than those with a contrast ratio of 0.5 or greater (P = .006, P = .004, and P = .02, respectively). The grade of histologic differentiation was well differentiated in 19 of 22 adenocarcinomas with a contrast ratio of less than 0.5 (86%), which was a greater frequency than the 4 (18%) of 22 adenocarcinomas with a contrast ratio of 0.5 or greater (P < .001).

CONCLUSION: Clinical T1 N0 M0 lung adenocarcinomas with a contrast ratio of less than 0.5 usually did not have lymph node metastasis, had less tumor involvement of vessels or pleura, and were more frequently well differentiated than those with a contrast ratio of 0.5 or greater. Limited lung resection could be indicated, lymph node dissection or mediastinoscopy could be reduced, or both in this type of adenocarcinoma.

This article has been cited by other articles:

				B. D. Kozower, B. F. Meyers, C. E. Reed, D. R. Jones, P. A. Decker, and J. B. Putnam Jr Does Positron Emission Tomography Prevent Nontherapeutic Pulmonary Resections for Clinical Stage IA Lung Cancer? Ann. Thorac. Surg., April 1, 2008; 85(4): 1166 - 1170. [Abstract] [Full Text] [PDF]

				M. Okada, S. Tauchi, K. Iwanaga, T. Mimura, Y. Kitamura, H. Watanabe, S. Adachi, T. Sakuma, and C. Ohbayashi Associations among bronchioloalveolar carcinoma components, positron emission tomographic and computed tomographic findings, and malignant behavior in small lung adenocarcinomas J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1448 - 1454. [Abstract] [Full Text] [PDF]

				C. Schimmer, K. Neukam, and O. Elert Staging of non-small cell lung cancer: clinical value of positron emission tomography and mediastinoscopy Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 418 - 423. [Abstract] [Full Text] [PDF]

				K.-i. Watanabe, H. Nomori, T. Ohtsuka, T. Naruke, A. Ebihara, H. Orikasa, K. Yamazaki, K. Uno, T. Kobayashi, and T. Goya [F-18]Fluorodeoxyglucose Positron Emission Tomography Can Predict Pathological Tumor Stage and Proliferative Activity Determined by Ki-67 in Clinical Stage IA Lung Adenocarcinomas Jpn. J. Clin. Oncol., July 1, 2006; 36(7): 403 - 409. [Abstract] [Full Text] [PDF]

				H. Nomori, N. Kosaka, K. Watanabe, T. Ohtsuka, T. Naruke, T. Kobayashi, and K. Uno 11C-Acetate Positron Emission Tomography Imaging for Lung Adenocarcinoma 1 to 3 cm in Size With Ground-Glass Opacity Images on Computed Tomography Ann. Thorac. Surg., December 1, 2005; 80(6): 2020 - 2025. [Abstract] [Full Text] [PDF]