Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours

Holly A Pattenden, Maria Leung, Emma Beddow, Michael Dusmet, Andrew G Nicholson, Michael Shackcloth, Saifullah Mohamed, Adnan Darr, Babu Naidu, Swetha Iyer, Adrian Marchbank, Amy Greenwood, Doug West, Felice Granato, Alan Kirk, Priyadharshanan Ariyaratnam, Mahmoud Loubani, Eric Lim, UK Thoracic Surgery Collaborative

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Positron emission tomography-CT (PET-CT) is one of the initial mediastinal staging modality for non-small cell lung cancer; however, the clinical utility in carcinoid tumours is uncertain. We sought to determine the test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours. We collated data from seven institutions, performing a retrospective search on pathological databases for a consecutive series of patients who underwent thoracic surgery (with lymph nodal dissection) for carcinoid tumours with preoperative PET-CT staging. PET-CT results were compared with the reference standard of pathologic results obtained from lymph node dissection and test performance reported using sensitivity and specificity. From November 1999 to January 2013, 247 patients from seven institutions underwent surgery for carcinoid tumours with a corresponding preoperative PET-CT scan. The mean age of the patients was 61 (SD 15, range 73) and 84 were male patients (34%). The pathologic subtype was typical carcinoid in 217 patients (88%) and atypical carcinoid in 30 patients (12%). Results from lymph node dissection were obtained in 207 patients. The calculated sensitivity and specificity of PET-CT to identify mediastinal lymph node disease was 33% (95% CI 4% to 78%) and 94% (95% CI 89% to 97%), respectively. Our results indicate that PET-CT has a poor sensitivity but good specificity to detect the presence of mediastinal lymph node metastases in pulmonary carcinoid tumours. Mediastinal lymph node metastases cannot be ruled out with negative PET-CT uptake, and if the absence of mediastinal lymph node disease is a prerequisite for directing management, tissue sampling should be undertaken.

Original languageEnglish
Pages (from-to)379-381
Number of pages3
Issue number4
Early online date14 Aug 2014
Publication statusPublished - Apr 2015


  • Aged
  • Carcinoid Tumor
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Neoplasms
  • Lymphatic Metastasis
  • Male
  • Mediastinum
  • Middle Aged
  • Multimodal Imaging
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed


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