BACKGROUND: F-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) scanning has become a critically important tool in diagnosis and management of non-small-cell lung cancer. However, the effectiveness of (18)F-FDG-PET as a diagnostic tool for small-sized lung cancer is controversial. The purpose of this study was to examine the accuracy of( 18)F-FDG-PET in relation to Noguchi's classification in the diagnosis of small peripheral non-small-cell lung cancer. METHODS: Between January 2003 and April 2006, 150 patients with peripheral lung lesions who were undergoing chest computed tomography (CT),( 18)F-FDG-PET, and operation were analyzed. RESULTS: Eighty-three patients had malignant lesions, and 67 patients had benign lesions. PET had a sensitivity, specificity, positive predictive value, and negative predictive value of 75.9%, 64.1%, 72.4%, and 68.3%, respectively. In 37 patients with peripheral lung cancer measuring 2.0 cm or less in the greatest diameter, the sensitivity was 51.4% and the specificity was 51.9%. Among them, all 4 cases of Noguchi type A adenocarcinoma [localized bronchioloalveolar carcinoma (LBAC)], 4 of 5 type B and 8 of 17 type C were false negative, while 9 of 11 (81.8%) types D, E, and F (invasive carcinomas without a BAC component) were true positive. CONCLUSION: The accuracy of( 18)F-FDG-PET is generally low in distinguishing malignancy from benign lesions in small lesions (<2.0-cm diameter). The significance of PET as a diagnostic tool is small, especially when the tumor has a ground-glass component at a high rate. The sensitivity of PET is high in small invasive carcinomas without a BAC component, but it is difficult to distinguish carcinoma from benign tumor from its image.
BACKGROUND: F-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) scanning has become a critically important tool in diagnosis and management of non-small-cell lung cancer. However, the effectiveness of (18)F-FDG-PET as a diagnostic tool for small-sized lung cancer is controversial. The purpose of this study was to examine the accuracy of( 18)F-FDG-PET in relation to Noguchi's classification in the diagnosis of small peripheral non-small-cell lung cancer. METHODS: Between January 2003 and April 2006, 150 patients with peripheral lung lesions who were undergoing chest computed tomography (CT),( 18)F-FDG-PET, and operation were analyzed. RESULTS: Eighty-three patients had malignant lesions, and 67 patients had benign lesions. PET had a sensitivity, specificity, positive predictive value, and negative predictive value of 75.9%, 64.1%, 72.4%, and 68.3%, respectively. In 37 patients with peripheral lung cancer measuring 2.0 cm or less in the greatest diameter, the sensitivity was 51.4% and the specificity was 51.9%. Among them, all 4 cases of Noguchi type A adenocarcinoma [localized bronchioloalveolar carcinoma (LBAC)], 4 of 5 type B and 8 of 17 type C were false negative, while 9 of 11 (81.8%) types D, E, and F (invasive carcinomas without a BAC component) were true positive. CONCLUSION: The accuracy of( 18)F-FDG-PET is generally low in distinguishing malignancy from benign lesions in small lesions (<2.0-cm diameter). The significance of PET as a diagnostic tool is small, especially when the tumor has a ground-glass component at a high rate. The sensitivity of PET is high in small invasive carcinomas without a BAC component, but it is difficult to distinguish carcinoma from benign tumor from its image.
Authors: Robert James Cerfolio; Buddhiwardhani Ojha; Ayesha S Bryant; Vanguru Raghuveer; James M Mountz; Alfred A Bartolucci Journal: Ann Thorac Surg Date: 2004-09 Impact factor: 4.330
Authors: Cecelia S Yap; Johannes Czernin; Michael C Fishbein; Robert B Cameron; Christiaan Schiepers; Michael E Phelps; Wolfgang A Weber Journal: Chest Date: 2006-02 Impact factor: 9.410
Authors: M Noguchi; A Morikawa; M Kawasaki; Y Matsuno; T Yamada; S Hirohashi; H Kondo; Y Shimosato Journal: Cancer Date: 1995-06-15 Impact factor: 6.860
Authors: Cecelia S Yap; Christiaan Schiepers; Michael C Fishbein; Michael E Phelps; Johannes Czernin Journal: Eur J Nucl Med Mol Imaging Date: 2002-06-04 Impact factor: 9.236
Authors: Stephen A Deppen; Jeffrey D Blume; Clark D Kensinger; Ashley M Morgan; Melinda C Aldrich; Pierre P Massion; Ronald C Walker; Melissa L McPheeters; Joe B Putnam; Eric L Grogan Journal: JAMA Date: 2014-09-24 Impact factor: 56.272