Comparison of Computed Tomography and 57Co-Bleomycin Scintigraphy in Staging the Mediastinal Lymph Nodes of Patients with Non-Small-Cell Lung Cancer

J. G. van der Laan; A. van den Brink; W. J. de Boer; D. A. Piers; H. Beekhuis; R. A. Kengen

doi:10.1055/s-0038-1629541

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1990; 29(06): 259-263
DOI: 10.1055/s-0038-1629541

ÜBersichtsartikel - Review Articles

Schattauer GmbH

Comparison of Computed Tomography and ⁵⁷Co-Bleomycin Scintigraphy in Staging the Mediastinal Lymph Nodes of Patients with Non-Small-Cell Lung Cancer

J. G. van der Laan

¹From the department of Nuclear Medicine, Roman Catholic Hospital, Groningen, The Netherlands

,

A. van den Brink

²From the department of Thoracic Surgery, The Netherlands

,

W. J. de Boer

²From the department of Thoracic Surgery, The Netherlands

,

D. A. Piers

³From the department of Nuclear Medicine, Groningen University Hospital, The Netherlands

,

H. Beekhuis

³From the department of Nuclear Medicine, Groningen University Hospital, The Netherlands

,

R. A. Kengen

³From the department of Nuclear Medicine, Groningen University Hospital, The Netherlands

› Author Affiliations

Abstract

The value of computed tomography (CT) and of ⁵⁷Co-bleomycin scintigraphy (⁵⁷Co-BLM) in staging the mediastinal lymph nodes was compared in 28 patients suffering from non-small-cell lung cancer. The results were assessed against the pathological findings obtained during thoracotomy or mediastinoscopy. CT staging of the mediastinum had a sensitivity of 75%, a specificity of 80%, an accuracy of 79%, a positive predictive index of 60% and a negative predictive index of 89%. ⁵⁷Co-BLM scintigraphic staging had a sensitivity of 43%, a specificity of 94%, an accuracy of 80%, a positive predicitive index of 75% and a negative predictive index of 81 %. In this small series these differences were not statistically significant; it thus appears that CT and ⁵⁷Co-BLM are of equal value in staging the mediastinum. Mediastinoscopy is not contributory in case of a negative CT or ⁵⁷Co-BLM. A positive CT or ⁵⁷Co-BIM, however, indicates the need for histological verification of the mediastinal findings.

Zusammenfassung

Es wurde der Wert der Computertomographie (CT) und der Szintigraphie mit ⁵⁷Co beim Staging mediastinaler Lymphknoten bei 28 Patienten mit nichtkleinzelligen Bronchialkarzinomen festgestellt und mit den Befunden aus Thorakotomie oder Mediastinoskopie verglichen. Die Sensitivität der Computertomographie beim mediastinalen Staging betrug 75%, die Spezifität 80% und die Treffsicherheit 79%. Der positive Vorhersageindex war 60, der negative 89%. Die Sensitivität der Szintigraphie betrug 43%, die Spezifität 94 und die Treffsicherheit 80%. Der positive Vorhersage-index war 75%, der negative 81%. Bei dieser relativ kleinen Untersuchungsreihe fand sich keine statistisch signifikante Differenz; CT und ⁵⁷Co-BLM sind für das Staging des Mediastinums offenbar gleichwertig. Die Mediastinoskopie ist bei negativem CT oder ⁵⁷Co-BLM-Befund nicht weiterführend. Im Falle eines positiven CT oder ⁵⁷Co-BLM-Befundes erscheint jedoch eine histologische Verifikation des mediastinalen Befundes angezeigt.

Full Text

References

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