Journal List > J Korean Soc Radiol > v.66(1) > 1087139

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Ryu, Oh, and Jeong: Supraclavicular Lymph Node Metastasis from Various Malignancies: Assessment with 18F-Fluorodeoxyglucose Positron Emission Tomography/CT, Contrast-Enhanced CT and Ultrasound
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Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2012; 66(1): 83-92.

Published online: 12 January 2012

DOI: https://doi.org/10.0000/jksr.2012.66.1.83

Supraclavicular Lymph Node Metastasis from Various Malignancies: Assessment with 18F-Fluorodeoxyglucose Positron Emission Tomography/CT, Contrast-Enhanced CT and Ultrasound

Eun Bi Ryu, MD, Kyung Seung Oh, MD, Kyung Soon Jeong, MD

Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.

Corresponding author: Eun Bi Ryu, MD. Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, 34 Amnam-dong, Seo-gu, Busan 602-072, Korea. Tel. 82-51-990-6341, Fax. 82-51-255-2764, yvette1124@hanmail.net

Received 10 September 2011       Accepted 13 October 2011

Copyright © 2012 The Korean Society of Radiology

Abstract

Purpose

The purpose of this study is to compare the usefulness of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/CT, contrast-enhanced CT and ultrasound (US) for diagnosing metastatic supraclavicular lymph nodes.

Materials and Methods

This study included 53 supraclavicular lymph nodes of 48 consecutive patients with various malignancies observed on 18F-FDG PET/CT, contrast-enhanced CT and US. Detection of supraclavicular lymph nodes was determined by 18F-FDG PET/CT where uptake was greater than that of surrounding tissue and contrast-enhanced CT with a node short-axis diameter of 5 mm or more. On US, we classified the supraclavicular lymph node as benign or malignant by sonographic criteria. The diagnostic values of these modalities were compared in the detection of metastatic supraclavicular lymph nodes.

Results

Metastatic supraclavicular lymph nodes were diagnosed cytologically in 44 (83%) of 53 lesions. In the detection of metastatic supraclavicular lymph nodes, the diagnostic accuracies of 18F-FDG PET/CT, contrast-enhanced CT, and US were 92%, 89%, and 91%, respectively. The specificity (67%) and negative predictive value (86%) of 18F-FDG PET/CT were higher than those of contrast-enhanced CT and US.

Conclusion

18F-FDG PET/CT is more useful for detecting and characterizing supraclavicular lymph nodes in patients with cancer, because of its high specificity and negative predictive value.

Keywords: Lymph Node, Metastasis, Positron Emission Tomography/CT, Malignancy

References

1. Fultz PJ, Harrow AR, Elvey SP, Feins RH, Strang JG, Wandtke JC, et al. Sonographically guided biopsy of supraclavicular lymph nodes: a simple alternative to lung biopsy and other more invasive procedures. AJR Am J Roentgenol. 2003. 180:1403–1409.
2. van Overhagen H, Brakel K, Heijenbrok MW, van Kasteren JH, van de Moosdijk CN, Roldaan AC, et al. Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT. Radiology. 2004. 232:75–80.
3. Blum A, Schlagenhauff B, Stroebel W, Breuninger H, Rassner G, Garbe C. Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma: results of a prospective study of 1288 patients. Cancer. 2000. 88:2534–2539.
4. van Overhagen H, Laméris JS, Berger MY, van der Voorde F, Tilanus HW, Klooswijk AI, et al. Supraclavicular lymph node metastases in carcinoma of the esophagus and gastroesophageal junction: assessment with CT, US, and US-guided fine-needle aspiration biopsy. Radiology. 1991. 179:155–158.
5. Baatenburg de Jong RJ, Rongen RJ, Laméris JS, Harthoorn M, Verwoerd CD, Knegt P. Metastatic neck disease. Palpation vs ultrasound examination. Arch Otolaryngol Head Neck Surg. 1989. 115:689–690.
6. Fultz PJ, Feins RH, Strang JG, Wandtke JC, Johnstone DW, Watson TJ, et al. Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US. Radiology. 2002. 222:245–251.
7. Monsó E, Montserrat JM, Abad J, Texidó A, Roig J, Morera J. Usefulness of supraclavicular ultrasonography in the staging of lung cancer. Lung. 1992. 170:243–244.
8. Sugama Y, Kitamura S. Ultrasonographic evaluation of neck and supraclavicular lymph nodes metastasized from lung cancer. Intern Med. 1992. 31:160–164.
9. Chang DB, Yang PC, Yu CJ, Kuo SH, Lee YC, Luh KT. Ultrasonography and ultrasonographically guided fine-needle aspiration biopsy of impalpable cervical lymph nodes in patients with non-small cell lung cancer. Cancer. 1992. 70:1111–1114.
10. Goldberg RP, Austin RM. Computed tomography of axillary and supraclavicular adenopathy. Clin Radiol. 1985. 36:593–596.
11. Vassallo P, Wernecke K, Roos N, Peters PE. Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology. 1992. 183:215–220.
12. Verhagen AF, Bootsma GP, Tjan-Heijnen VC, van der Wilt GJ, Cox AL, Brouwer MH, et al. FDG-PET in staging lung cancer: how does it change the algorithm? Lung Cancer. 2004. 44:175–181.
13. Dwamena BA, Sonnad SS, Angobaldo JO, Wahl RL. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s--meta-analytic comparison of PET and CT. Radiology. 1999. 213:530–536.
14. Marom EM, McAdams HP, Erasmus JJ, Goodman PC, Culhane DK, Coleman RE, et al. Staging non-small cell lung cancer with whole-body PET. Radiology. 1999. 212:803–809.
15. Wahl RL, Quint LE, Greenough RL, Meyer CR, White RI, Orringer MB. Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation. Radiology. 1994. 191:371–377.
16. Steinert HC, Hauser M, Allemann F, Engel H, Berthold T, von Schulthess GK, et al. Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling. Radiology. 1997. 202:441–446.
17. Magnani P, Carretta A, Rizzo G, Fazio F, Vanzulli A, Lucignani G, et al. FDG/PET and spiral CT image fusion for medistinal lymph node assessment of non-small cell lung cancer patients. J Cardiovasc Surg (Torino). 1999. 40:741–748.
18. Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med. 2003. 348:2500–2507.
19. Antoch G, Stattaus J, Nemat AT, Marnitz S, Beyer T, Kuehl H, et al. Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology. 2003. 229:526–533.
20. Som PM, Curtin HD, Mancuso AA. Imaging-based nodal classification for evaluation of neck metastatic adenopathy. AJR Am J Roentgenol. 2000. 174:837–844.
21. Madu CN, Quint DJ, Normolle DP, Marsh RB, Wang EY, Pierce LJ. Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy. Radiology. 2001. 221:333–339.
22. Ahuja AT, Ying M. Sonographic evaluation of cervical lymph nodes. AJR Am J Roentgenol. 2005. 184:1691–1699.
23. van Overhagen H, Laméris JS, Zonderland HM, Tilanus HW, van Pel R, Schütte HE. Ultrasound and ultrasound-guided fine needle aspiration biopsy of supraclavicular lymph nodes in patients with esophageal carcinoma. Cancer. 1991. 67:585–587.
24. Sung YM, Lee KS, Kim BT, Kim S, Kwon OJ, Choi JY, et al. Nonpalpable supraclavicular lymph nodes in lung cancer patients: preoperative characterization with 18F-FDG PET/CT. AJR Am J Roentgenol. 2008. 190:246–252.
25. Cervin JR, Silverman JF, Loggie BW, Geisinger KR. Virchow's node revisited. Analysis with clinicopathologic correlation of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes. Arch Pathol Lab Med. 1995. 119:727–730.
26. Jackson RS, Schlarman TC, Hubble WL, Osman MM. Prevalence and patterns of physiologic muscle uptake detected with whole-body 18F-FDG PET. J Nucl Med Technol. 2006. 34:29–33.
27. Cohade C, Osman M, Pannu HK, Wahl RL. Uptake in supraclavicular area fat ("USA-Fat"): description on 18F-FDG PET/CT. J Nucl Med. 2003. 44:170–176.
28. Yeung HW, Grewal RK, Gonen M, Schöder H, Larson SM. Patterns of (18)F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med. 2003. 44:1789–1796.
29. Dunphy MP, Freiman A, Larson SM, Strauss HW. Association of vascular 18F-FDG uptake with vascular calcification. J Nucl Med. 2005. 46:1278–1284.
30. Ben-Haim S, Israel O. PET/CT for atherosclerotic plaque imaging. Q J Nucl Med Mol Imaging. 2006. 50:53–60.
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