Diagnostic accuracy of N-stage in non-small cell lung cancer. Comparison of CT, MRI, and PET scan

The status of lymph node (N-stage) is one of the most important prognostic factors for patients with non-small-cell lung cancers. In this article the comparison of diagnostic accuracy of N-stage among CT, MRI, and PET scans was reviewed. On the result of meta-analytic comparison of CT and PET, mean sensitivity and specificity were 79% and 91%, respectively for PET and 60% and 77% respectively for CT. Although the reports of MRI diagnosis were limited, one manuscript showed that the sensitivity and specificity of MR diagnosis with short inversion time inversion recovery (STIR) technique were 75% and 92%, respectively and 67% and 85% respectively for conventional MRI. Preoperative staging has relied on CT scans, but PET is superior to CT for mediastinal staging of non-small cell lung cancer and is recommended as the non-invasive, final confirmatory investigation when the CT shows resectable disease. (author)