Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Accuracy of Nodal Staging with Integrated PET/CT Scanning in Non-small Cell Lung Cancer

양전자단층촬영/전산화단층촬영(integrated PET/CT)을 이용한 비소세포폐암의 림프절 병기판정

  • Kim, Ji-Hoon (Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, College of Medicine, Hanyang University) ;
  • Chung, Won-Sang (Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, College of Medicine, Hanyang University) ;
  • Kim, Young-Hak (Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, College of Medicine, Hanyang University) ;
  • Kim, Hyuck (Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, College of Medicine, Hanyang University) ;
  • Jeon, Seok-Chol (Department of Diagnostic Radiology, College of Medicine, Hanyang University)
  • 김지훈 (한양대학교 의과대학 한양대학교병원 흉부외과학교실) ;
  • 정원상 (한양대학교 의과대학 한양대학교병원 흉부외과학교실) ;
  • 김영학 (한양대학교 의과대학 한양대학교병원 흉부외과학교실) ;
  • 김혁 (한양대학교 의과대학 한양대학교병원 흉부외과학교실) ;
  • 전석철 (한양대학교 의과대학 영상의학교실)
  • Received : 2010.06.07
  • Accepted : 2010.08.17
  • Published : 2010.12.05
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Abstract

Background: For staging primary lung cancer, integrated positron emission tomography/computed tomography (PET/CT) imaging is popular. The purpose of this study was to evaluate the accuracy of PET/CT scanning in lymph nodal staging of lung cancer. Material and Method: We studied 48 patients who had received CT, PET/CT and pulmonary resections due to primary non-small cell lung cancer in our hospital between January 2006 and August 2009. Mediastinal lymph nodes were classified as superior mediastinal nodes, aortic nodes, inferior mediastinal nodes, or N1 nodes. We compared the power of CT and PET/CT for diagnosing pulmonary lymph nodes for each of the four types of nodes. Result: PET/CT was more sensitive than CT for all groups except inferior mediastinal nodes. However, the differences were not significant (McNemar's test: superior mediastinal nodes, p=0.109; aortic nodes, p=1.000; inferior mediastinal nodes, p=0.625, N1 nodes, p=0.424). Conclusion: The accuracy of PET/CT is similar to that of CT alone for staging lymph nodes. The two imaging modalities might be used as complementary, cooperative tools. We expect that integrated PET/CT will be found to be significantly mmore sensitive after more trials are done and more data is accumulated.

배경: 최근 양전자단층촬영/전산화단층촬영(PET/CT) 검사가 점차 보편화 되어가고 있다. 림프절 병기 진단에 있어서 CT와 PET/CT의 유용성 및 실효성에 대해 알아보고자 하였다. 대상 및 방법: 2006년 1월부터 2009년 8월까지 본원에서 악성종양으로 폐절제술을 받은 110명의 환자 중, 술 전 본원에서 조영증강 흉부전산화단층촬영 (CT)과 전신 양전자단층촬영/전산화단층촬영 결합영상(PET/CT fusion imaging, integrated PET/CT) 검사를 모두 시행 받고, 술 후 원발성 비소세포폐암을 진단 받은 48명의 환자들을 대상으로 하였다. 림프절을 superior mediastinal nodes, aortic nodes, inferior mediastinal nodes, 그리고 Nl nodes의 4군으로 분류하여 CT와 PET/CT의 진단력에 대한 통계분석을 실시하였다. 결과: 4개의 군 가운데, inferior mediastinal nodes를 제외한 나머지 군들은 CT보다 PET/CT에서 민감도가 향상되는 소견을 보였다. 하지만 두 검사의 진단력 차이를 각각의 군에 대해 McNemar's test를 사용하여 분석한 결과 통계적으로 유의한 차이는 보이지 않았다(p-values; superior mediastinal nodes=0.109, aortic nodes=1.000, inferior mediastinal nodes=0.625, Nl nodes=0.424). 결론: 본 연구에서 종격동 림프절에 대한 PET/CT의 진단력은 조영증강 CT와 비슷한 정도로 나타났다. 현재 PET/CT는 CT와 상호보완적인 수단으로써 사용되어야 할 것으로 사료되며, 앞으로 촬영 기술 및 판독 수준이 더욱 발전하고 결과들이 많이 축적되었을 때에는 보다 좋은 성적을 보일 것으로 생각된다.

Keywords

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