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. 2021 Apr;12(8):1203-1209.
doi: 10.1111/1759-7714.13899. Epub 2021 Feb 25.

Preoperative consolidation-to-tumor ratio is effective in the prediction of lymph node metastasis in patients with pulmonary ground-glass component nodules

Yi-Chung Chen  1 , Yi-Han Lin  2 , Hung-Che Chien  1   3 , Po-Kuei Hsu  1 , Jung-Jyh Hung  1 , Chien-Sheng Huang  1 , Chih-Cheng Hsieh  1   4 , Wen-Hu Hsu  1 , Han-Shui Hsu  1   3
Affiliations

Preoperative consolidation-to-tumor ratio is effective in the prediction of lymph node metastasis in patients with pulmonary ground-glass component nodules

Yi-Chung Chen et al. Thorac Cancer. 2021 Apr.

Abstract

Background: Preoperative positron emission tomography/computed tomography (PET/CT) is recommended as a guideline for staging of lung cancer. However, for patients with pulmonary ground-glass opacity (GGO) nodules who are supposed to have a relatively low risk of incidence of lymphatic metastasis, it remains uncertain whether PET/CT is more effective than consolidation-to-tumor ratio (CTR) in the prediction of regional lymphatic metastasis.

Methods: The data on patients who underwent surgery for lung cancer from 2011 to 2016 were collected retrospectively, which included CTR, results of PET/CT, and pathological characteristics. The patients who had undergone preoperative PET/CT were identified to find the risk factors for lymphatic metastasis. A receiver operating characteristic (ROC) curve and multiple logistic regression was utilized to clarify the predictive value of CTR and main tumor maximal standardized uptake value (SUVmax).

Results: Among 217 patients who had PET/CT before lobectomy, chest computed tomography revealed that 75 patients had CTR greater than 62%. The patients with lymphatic metastasis were shown to have higher CTR and higher main tumor SUVmax. Multiple logistic regression showed that younger age (<60 years), higher main tumor SUVmax on PET/CT, and greater CTR were independent predictive factors for lymphatic metastasis. The area under the ROC curve was comparable, 0.817 for CTR, and 0.816 for main tumor SUVmax.

Conclusions: The present study revealed that CTR was not inferior to main tumor SUVmax considering the predictive power for lymphatic metastasis preoperatively in lung cancer patients with a GGO component. PET/CT might not be necessary preoperatively in selected patients.

Keywords: consolidation-to-tumor ratio; ground-glass opacity; lung cancer; positron emission tomography/computed tomography.

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Conflict of interest statement

The authors have no conflicts of interest to declare, and there was no funding for this study.

Figures

FIGURE 1
FIGURE 1
Flow diagram for patient selection (positron emission tomography/computed tomography [PET/CT])
FIGURE 2
FIGURE 2
Receiver operating characteristic (ROC) curve for consolidation‐to‐tumor ratio (CTR) on chest computed tomography scan and main tumor maximal standardized uptake value (SUVmax) on PET/CT demonstrated a comparable area under the ROC curve, 0.816 for main tumor SUVmax and 0.817 for CTR
See this image and copyright information in PMC

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