UNLABELLED: Recent advances in the technology of helical multidetector CT allow precise evaluations of nodule hemodynamics. In addition, the efficacy of tissue characterization has improved, and now sensitivity and specificity of >90% are achieved. Moreover, the efficacy of PET for the tissue characterization of solitary pulmonary nodules (SPNs) has also become of importance. The purpose of this study was to compare the diagnostic accuracy of helical dynamic (HD) CT (HDCT) and integrated PET/CT for pulmonary nodule characterization. METHODS: One hundred nineteen patients with an SPN underwent both HDCT (unenhanced scans, followed by series of images at 30, 60, 90, 120 s and at 5 and 15 min after intravenous injection of contrast medium) and integrated PET/CT. On HDCT, a nodule was regarded as malignant with a net enhancement of > or =25 Hounsfield units (HU) and a washout of 5-31 HU. On integrated PET/CT, nodules were considered malignant with a > or =3.5 maximum standardized uptake value and an 18F-FDG uptake greater than that of mediastinal structures. The sensitivity, specificity, and accuracy of the 2 modalities for malignancy were compared using the McNemar test. RESULTS: There were 79 malignant and 40 benign nodules. The sensitivity, specificity, and accuracy for malignancy on HDCT were 81% (64/79 nodules), 93% (37/40), and 85% (101/119), respectively, whereas those on integrated PET/CT were 96% (76/79), 88% (35/40), and 93% (111/119), respectively (P = 0.008, 0.727, and 0.011, respectively). All malignant nodules were interpreted correctly on either HDCT or PET/CT. CONCLUSION: Integrated PET/CT is more sensitive and accurate than HDCT for the malignant nodule characterization; therefore, PET/CT may be performed as the first-line evaluation tool for SPN characterization. Because HDCT has high specificity and acceptable sensitivity and accuracy, it may be a reasonable alternative for nodule characterization when PET/CT is unavailable.
UNLABELLED: Recent advances in the technology of helical multidetector CT allow precise evaluations of nodule hemodynamics. In addition, the efficacy of tissue characterization has improved, and now sensitivity and specificity of >90% are achieved. Moreover, the efficacy of PET for the tissue characterization of solitary pulmonary nodules (SPNs) has also become of importance. The purpose of this study was to compare the diagnostic accuracy of helical dynamic (HD) CT (HDCT) and integrated PET/CT for pulmonary nodule characterization. METHODS: One hundred nineteen patients with an SPN underwent both HDCT (unenhanced scans, followed by series of images at 30, 60, 90, 120 s and at 5 and 15 min after intravenous injection of contrast medium) and integrated PET/CT. On HDCT, a nodule was regarded as malignant with a net enhancement of > or =25 Hounsfield units (HU) and a washout of 5-31 HU. On integrated PET/CT, nodules were considered malignant with a > or =3.5 maximum standardized uptake value and an 18F-FDG uptake greater than that of mediastinal structures. The sensitivity, specificity, and accuracy of the 2 modalities for malignancy were compared using the McNemar test. RESULTS: There were 79 malignant and 40 benign nodules. The sensitivity, specificity, and accuracy for malignancy on HDCT were 81% (64/79 nodules), 93% (37/40), and 85% (101/119), respectively, whereas those on integrated PET/CT were 96% (76/79), 88% (35/40), and 93% (111/119), respectively (P = 0.008, 0.727, and 0.011, respectively). All malignant nodules were interpreted correctly on either HDCT or PET/CT. CONCLUSION: Integrated PET/CT is more sensitive and accurate than HDCT for the malignant nodule characterization; therefore, PET/CT may be performed as the first-line evaluation tool for SPN characterization. Because HDCT has high specificity and acceptable sensitivity and accuracy, it may be a reasonable alternative for nodule characterization when PET/CT is unavailable.
Authors: Marco Spadafora; Leonardo Pace; Laura Evangelista; Luigi Mansi; Francesco Del Prete; Giorgio Saladini; Paolo Miletto; Stefano Fanti; Silvana Del Vecchio; Luca Guerra; Giovanna Pepe; Giuseppina Peluso; Emanuele Nicolai; Giovanni Storto; Marco Ferdeghini; Alessandro Giordano; Mohsen Farsad; Orazio Schillaci; Cesare Gridelli; Alberto Cuocolo Journal: Eur J Nucl Med Mol Imaging Date: 2018-05-05 Impact factor: 9.236
Authors: Johan Coolen; Johan Vansteenkiste; Frederik De Keyzer; Herbert Decaluwé; Walter De Wever; Christophe Deroose; Christophe Dooms; Eric Verbeken; Paul De Leyn; Vincent Vandecaveye; Dirk Van Raemdonck; Kristiaan Nackaerts; Steven Dymarkowski; Johny Verschakelen Journal: Eur Radiol Date: 2013-10-31 Impact factor: 5.315
Authors: Sandra Pauls; Andreas K Buck; Gisela Halter; Felix M Mottaghy; Rainer Muche; Christina Bluemel; Susanne Gerstner; Stefan Krüger; Gerhard Glatting; Ludger Sunder-Plassmann; Peter Möller; Hans-Jürgen Brambs; Sven N Reske Journal: Mol Imaging Biol Date: 2008-01-16 Impact factor: 3.488