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To assess ability of pet ct to differentitiate benign and malignant f-18 FDG pet-ct positive peripheral lymph nodes in post treatment cancer patients by histopathological correlation

Author: 
Thangalakshmi Sivathapandi, Shelley Simon and Indirani Elangovan
Subject Area: 
Health Sciences
Abstract: 

Objective: Our study was focused on patients with various types of malignancies undergoing follow up 18F FDG PET-CT imaging after definitive cancer treatment to assess the ability of F-18 FDG PET CT to differentiate benign and malignant metabolically active peripheral lymph nodes (LNs) with histopathological (HP) correlation. Methods: Follow up of 115 treated cancer patients with 18F FDG PET-CT imaging who had metabolically active peripheral LNs were included in this prospective study which consist 60 males and 55 females (15-75 years). Various indices like retention index (RI), delayed tumor to non tumor ratio (De T: NT), difference in SUV max (D SUV) were calculated. Receiver operating characteristic (ROC) analysis and Spearman’s rank correlation was performed. The results of 18 F FDG PET- CT were correlated to the final HP results. Results: The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 18F FDG PET-CT to detect metastases in peripheral LNs in post therapy cancer patients were 96%, 75%, 89% and 90% respectively. 18F FDG PET-CT in post treatment setting had the maximum sensitivity (100%), NPV (100%) and PPV (89.65%) for supraclavicular nodes and maximum specificity (80%) for axillary nodes. The D-SUVmax, De T: NT ratio and RI of malignant LNs were significantly higher than benign LNs. Conclusion: 18F FDG PET-CT has high sensitivity and high NPV which helps to exclude metastasis and guides for metabolic biopsy and paves an important way in the follow up management of treated cancer patients.

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