N staging in non small cell lung cancer (NSCLC): performance of CT, PET-CT and endoscopic ultrasound in comparison with histopathology

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1 N staging in non small cell lung cancer (NSCLC): performance of CT, PET-CT and endoscopic ultrasound in comparison with histopathology Poster No.: C-1564 Congress: ECR 2011 Type: Scientific Paper Authors: A. Caulo, F. Maggi, L. Leccisotti, M. L. Calcagni, A. Larghi, A. Giordano, L. Bonomo; Rome/IT Keywords: Thorax, PET-CT, CT, PET, Comparative studies, Staging, Endoscopy, Neoplasia DOI: /ecr2011/C-1564 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 44

2 Purpose To evaluate performance of CT, 18F-FDG PET-CT and Endoscopic Ultrasound in Non Small Cell Lung Cancer (NSCLC) N Staging versus histopathology. Fig. References: A. Caulo; Department of Bioimages and Radiological Sciences, Catholic University of the Sacred Heart, Rome, ITALY Page 2 of 44

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12 Methods and Materials Nineteen patients affected by non small cell lung cancer, who underwent CT, PET-CT and Ultrasound-guided endoscopy (transbronchial and transesophageal) for staging purpose, were retrospectively enrolled. Fig. References: A. Caulo; Department of Bioimages and Radiological Sciences, Catholic University of the Sacred Heart, Rome, ITALY Page 12 of 44

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22 Results Staging exams showed good to excellent accuracy (71,4% for CT, 85,71% for PET-CT and 95,2% for US Endoscopy) versus cytologic or histopathological results. Fig. References: A. Caulo; Department of Bioimages and Radiological Sciences, Catholic University of the Sacred Heart, Rome, ITALY Page 22 of 44

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40 Conclusion PET-CT and US-guided endoscopy demonstrated a good performance in N staging of patients diagnosed with NSCLC. Fig. References: A. Caulo; Department of Bioimages and Radiological Sciences, Catholic University of the Sacred Heart, Rome, ITALY Images for this section: Page 40 of 44

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42 References 1. Yang W, Fu Z, Yu J, Yuan S, Zhang B, Li D, Xing L, Zhao D, Mu D, Sun X, Fang Y, Huang Y, Li W. Value of PET/CT versus enhanced CT for locoregional lymph nodes in non-small cell lung cancer. Lung Cancer Jul;61(1): Detterbeck FC, Jantz MA, Wallace M, Vansteenkiste J, Silvestri GA; American College of Chest Physicians. Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest Sep;132(3 Suppl):202S-220S. 3. Wallace MB, Pascual JM, Raimondo M, Woodward TA, McComb BL, Crook JE, Johnson MM, Al-Haddad MA, Gross SA, Pungpapong S, Hardee JN, Odell JA. Minimally invasive endoscopic staging of suspected lung cancer. JAMA Feb 6;299(5): Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, Postmus PE, Rusch V, Sobin L; International Association for the Study of Lung Cancer International Staging Committee; Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol Aug;2(8): Ryu JS, Choi NC, Fischman AJ, Lynch TJ, Mathisen DJ. FDG-PET in staging and restaging non-small cell lung cancer after neoadjuvant chemoradiotherapy: correlation with histopathology. Lung Cancer Feb;35(2): Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest Jun;111(6): Silvestri GA, Tanoue LT, Margolis ML, Barker J, Detterbeck F; American College of Chest Physicians. The noninvasive staging of non-small cell lung cancer: the guidelines. Chest. 2003; 123 (1 Suppl): 147S-156S. 8. Spira A, Ettinger DS. Multidisciplinary management of lung cancer. N Engl J Med 2004;350: De Leyn P, Stroobants S, De Wever W, Lerut T, Coosemans W, Decker G, Nafteux P, Van Raemdonck D, Mortelmans L, Nackaerts K, Vansteenkiste J. Prospective comparative study of integrated positron emission tomography-computed tomography Page 42 of 44

43 scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIAN2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. J Clin Oncol 2006;24: Graeter TP, Hellwig D, Hoffmann K, Ukena D, Kirsch CM, Schäfers HJ. Mediastinal lymph node staging in suspected lung cancer: comparison of positron emission tomography with F-18-fluorodeoxyglucose and mediastinoscopy. Ann Thorac Surg 2003;75: Annema JT, Rabe KF. State of the art lecture: EUS and EBUS in pulmonary medicine. Endoscopy 2006;38 Suppl 1:S Herth FJ, Krasnik M, Vilmann P. EBUS-TBNA for the diagnosis and staging of lung cancer. Endoscopy 2006 Jun;38 Suppl 1:S Vilmann P, Krasnik M, Larsen SS, Jacobsen GK, Clementsen P. Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy: a combined approach in the evaluation of mediastinal lesions. Endoscopy 2005;37: Gould MK, Kuschner WG, Rydzak CE, Maclean CC, Demas AN, Shigemitsu H. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med 2003;139: Toloza EM, Harpole L, Detterbeck F, McCrory DC. Invasive staging of non-small cell lung cancer: a review of the current evidence. Chest 2003;123: Takamochi K, Yoshida J, Murakami K, Niho S, Ishii G, Nishimura M, Nishiwaki Y, Suzuki K, Nagai K. Pitfalls in lymph node staging with positron emission tomography in non-small cell lung cancer patients. Lung Cancer 2005;47: De Leyn P, Lardinois D, Van Schil PE, Rami-Porta R, Passlick B, Zielinski M, Waller DA, Lerut T, Weder W. ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg 2007;32:1-8. Page 43 of 44

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