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Home > Vol 40, No 3 (2022) > Raruenrom

Prevalence and Significance of FDG-avid Mediastinal Lymph Nodes in Patients with Colorectal Cancer in a Tuberculosis-endemic Area

Yutapong Raruenrom, Daris Theerakulpisut, Mix Wannasarnmetha

Abstract

Objective: To find prevalence and causes of fluorodeoxyglucose (FDG)-avid mediastinal lymph nodes in patients with colorectal cancer in a tuberculosis-endemic area.
Material and Methods: For this study we enrolled patients with colorectal cancer who underwent Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT). Then, PET/CT images were reviewed by a nuclear medicine physician to find mediastinal lymph nodes with FDG uptake beyond the lung background defined as FDG-avid node. The degree of FDG uptake was graded and measured, and associated factors for presence of FDG-avid nodes were evaluated. The causes of FDG-avid nodes were also determined.
Results: A total of 109 patients (64 males; mean age 61.2 years) were studied. Seventy-five patients had FDG-avid mediastinal nodes; accounting for a prevalence of 68.8% (95% CI: 59.2-77.3%). Most of the patients had multiple and bilateral nodes; with the zones of hilar and interlobar being the most common location. Age ≥50 years was the only associated factor for FDG-avid nodes (OR of 3.16, p-value=0.035). Only one out of the 32 patients (with fulfilled followup criteria) had a metastatic node.
Conclusion: The prevalence of FDG-avid mediastinal nodes in colorectal cancer patients in a tuberculosis-endemic area was significantly high. Most of the lesions were benign in nature; thus, interpretation of these findings should be considered carefully to avoid false-positive results.

 Keywords

colorectal cancer; F-18 FDG PET/CT; mediastinal lymph node; tuberculosis-endemic area

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DOI: http://dx.doi.org/10.31584/jhsmr.2021833

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About The Authors

Yutapong Raruenrom
Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

Daris Theerakulpisut
Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

Mix Wannasarnmetha
Srinagarind Center of Excellence for Neurovascular Intervention and Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

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