Etiology of false-positive 18F-FDG PET/CT of mediastinal and hilar lymph nodes with surgical biopsy in cancer patients
DOI:
https://doi.org/10.35509/01239015.855Keywords:
positron emission tomography computed tomography, lymph node excision, mediastinum, anthracosisAbstract
Objective: This article aimed to describe the etiology of false-positive 18F-FDG PET/CT and its associations with clinical and imaging characteristics in cancer patients undergoing surgical biopsy of mediastinal and hilar lymph nodes at the Instituto Nacional de Cancerología (INC), Bogotá, Colombia, over a period of 8 years.
Methods: Retrospective and analytical study.
Results: In this study, 93 patients were included with a median age of 64 years (IQR: 55-70), and 57% were women. 35.5% of the patients had lung cancer, followed by lymphoma in 21.5%; 43% of the patients were smokers, and 17.2% had biomass combustion exposure. Of the 93 patients, 220 mediastinal and hilar lymph node stations were biopsied; 37 (16.8%) lymph node stations corresponded to false-positive 18F-FDG PET/CT. The etiology was anthracosis in 19 (51.4%) stations, sarcoidosis in 8 (21.6%) stations, negative for malignancy in 7 (18.9%) stations, and only two stations were granulomas. A statistically significant association was found between false positives and lymph node stations in patients ≥65 years (p=0.008) and patients with a history of smoking (p=0.021). In addition, an association was found between true positives and enlarged lymph nodes (p=0.033).
Conclusion: The main etiology of false-positive 18F-FDG PET/CT was anthracosis. In contrast, granulomas were not an
important etiology. An association was found between false positives and lymph node stations in patients ≥65 years and
patients with a history of smoking. Association was also found between true positives and enlarged lymph nodes in the
18F-FDG PET/CT.
Author Biographies
Carlos Carvajal, Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Mónica Naranjo, Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
2. Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
José Carreño, Grupo Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Grupo Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Luis Chinchilla, Cirugía de Tórax, Centro Oncológico de Antioquia, Envigado, Colombia.
4. Cirugía de Tórax, Centro Oncológico de Antioquia, Envigado, Colombia.
Fernando Alvarado, Cirugía de Tórax, Universidad El Bosque, Bogotá, D.C., Colombia.
5. Cirugía de Tórax, Universidad El Bosque, Bogotá, D.C., Colombia.
Miguel Buitrago, Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Ana Callejas, Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Rafael Beltrán, Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad Funcional Cirugía de Tórax, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
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