CHEST RADIOLOGY / ORIGINAL PAPER
PET-CT in mediastinal staging of non-small cell lung cancer: analysis of false results
Piotr Kocoń
4,5
1
Maria Skłodowska-Curie National Institute of Oncology, National Research Institute, Cracow, Poland
2
Department of Coronary Artery Disease and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland
3
Students Scientific Society, Jagiellonian University College of Medicine, Cracow, Poland
4
Department of Thoracic Surgery, John Paul II Hospital, Cracow, Poland
5
Department of Thoracic Surgery, Jagiellonian University College of Medicine, Cracow, Poland
These authors had equal contribution to this work
Submission date: 2025-01-13
Final revision date: 2025-02-15
Acceptance date: 2025-02-25
Publication date: 2025-05-19
Corresponding author
Adam Kużdżał
Department of Radiology, Maria Skłodowska-Curie National Institute of Oncology, National Research Institute, 11 Garncarska St., 31-115 Cracow, Poland
Department of Radiology, Maria Skłodowska-Curie National Institute of Oncology, National Research Institute, 11 Garncarska St., 31-115 Cracow, Poland
Pol J Radiol, 2025; 90: 234-238
KEYWORDS
PET-CTnon-small cell lung cancermediastinal stagingfalse-negative resultsfalse-positive resultslymph node metastasis
TOPICS
ABSTRACT
Purpose:
To analyse the risk and factors associated with false-negative (FN) and false-positive (FP) positron emission tomography-computed tomography (PET-CT) results in the mediastinal staging of non-small cell lung cancer.
Material and methods:
This retrospective cohort study analysed data from a prospective database. It included patients with lung cancer who underwent preoperative staging with PET-CT, endobronchial ultrasound, and endoscopic ultrasound, followed by curative-intent anatomical lung resection with systematic lymph node dissection. Statistical analyses were performed to identify factors associated with FN and FP PET-CT results.
Results:
Data from 781 patients were analysed. FN results were significantly associated with more advanced PET-CT-based stages and CT-based stage IIB. FP results were significantly associated with male sex, adenocarcinoma histology, CT-based disease stage, and SUVmax values of the primary tumour and lymph nodes.
Conclusions:
False-negative PET-CT results in the diagnosis of mediastinal lymph node involvement were more likely to occur in PET-CT-based stages IB and IIB and less likely to occur in stage IIIA. FP results were more likely to be expected in men, with higher SUVmax values of the primary tumour and a more advanced CT-based stage of the disease.
To analyse the risk and factors associated with false-negative (FN) and false-positive (FP) positron emission tomography-computed tomography (PET-CT) results in the mediastinal staging of non-small cell lung cancer.
Material and methods:
This retrospective cohort study analysed data from a prospective database. It included patients with lung cancer who underwent preoperative staging with PET-CT, endobronchial ultrasound, and endoscopic ultrasound, followed by curative-intent anatomical lung resection with systematic lymph node dissection. Statistical analyses were performed to identify factors associated with FN and FP PET-CT results.
Results:
Data from 781 patients were analysed. FN results were significantly associated with more advanced PET-CT-based stages and CT-based stage IIB. FP results were significantly associated with male sex, adenocarcinoma histology, CT-based disease stage, and SUVmax values of the primary tumour and lymph nodes.
Conclusions:
False-negative PET-CT results in the diagnosis of mediastinal lymph node involvement were more likely to occur in PET-CT-based stages IB and IIB and less likely to occur in stage IIIA. FP results were more likely to be expected in men, with higher SUVmax values of the primary tumour and a more advanced CT-based stage of the disease.
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