J Nucl Med 2000 Sep;41(9):1507-13
Sensitive detection of mediastinal lymph node metastasis of lung cancer
with 11C-choline PET.
Hara T, Inagaki K, Kosaka N, Morita T.
11C-choline and FDG are PET tracers used to visualize various malignancies. In this study,
we compared their capabilities in detecting mediastinal lymph node metastasis originating
from non-small cell lung cancer (NSCLC). METHODS: Twenty-nine patients with biopsy-proven
NSCLC were studied with PET. 11C-choline PET and FDG PET were performed from 5 and 40 min,
respectively, after injection of 370 MBq tracer. PET data were analyzed in terms of the
standardized uptake value (SUV). After the PET study, the patients underwent lung
resection and mediastinal lymph node dissection. The resected specimens were examined
pathologically, and the PET data were analyzed in reference to the pathologic data.
RESULTS: With 11C-choline, the SUV in metastasis was similar to the SUV in the primary
tumor, where the similarity of the SUV was 100% allowing for a 40% difference. With FDG,
small metastases were invisible on the PET image. The SUV of FDG in metastasis was much
smaller than that in the primary tumor, and the similarity of the SUV was only 19%
allowing for a 40% difference. When pathologic findings were used as standards, the
sensitivities of 11C-choline PET and FDG PET in detecting mediastinal lymph node
metastasis were 100% and 75%, respectively. CONCLUSION: 11C-choline PET was very effective
in detecting lymph node metastases in the mediastinum originating from NSCLC, with a
sensitivity of 100%. 11C-choline PET promises to be useful not only before surgery but
also after surgery.
