PURPOSE: The purpose of the study was to evaluate prospectively whether integrated 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is more accurate for determination of malignancy in newly diagnosed pulmonary lesions compared to separate interpretation of CT and FDG-PET. PROCEDURES: Two hundred and seventy-six patients with newly diagnosed lung lesions underwent FDG-PET/CT. Helical CT, FDG-PET, and FDG-PET/CT were interpreted separately to determine the performance of each imaging modality. Histopathology served as reference in all patients, and in further 60 patients, a benign lesion was verified at follow-up (mean follow-up of 1,040 days). RESULTS: Histology revealed malignant lung tumors in 216 of 276 patients. With PET and PET/CT, a significantly lower number of lesions were classified as equivocal compared to CT alone (p < 0.001). Assuming that equivocal lesions are benign, performance of diagnostic tests was as follows: sensitivity, specificity, and accuracy for CT was 94, 75, and 90%, for PET 97, 83, and 94% (p = 0.021), and for PET/CT 96, 87, and 94% (p = 0.010). Assuming that equivocal lesions are malignant, sensitivity, specificity, and accuracy for CT was 99, 37, and 86%, for PET 99, 77, and 94% (p < 0.001), and for PET/CT 98, 68, and 92% (p = 0.002). PET and PET/CT showed the highest concordance (K = 0.912; confidence interval 0.866-0.958). In lesions less than or equal to 3 cm, there was a significant difference in the performance of PET alone and multidetector row CT as well as PET/CT and multidetector row CT (p = 0.007), irrespective if equivocal findings were judged as malignant or benign. CONCLUSION: For differentiation of benign from malignant lung lesions, integrated FDG-PET/CT imaging was significantly more accurate than CT but not FDG-PET. The addition of metabolic imaging (FDG-PET) to morphological imaging (CT) leads to an increase in specificity and significantly reduced equivocal findings and is therefore recommended to further specify newly diagnosed lung lesions.
PURPOSE: The purpose of the study was to evaluate prospectively whether integrated 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is more accurate for determination of malignancy in newly diagnosed pulmonary lesions compared to separate interpretation of CT and FDG-PET. PROCEDURES: Two hundred and seventy-six patients with newly diagnosed lung lesions underwent FDG-PET/CT. Helical CT, FDG-PET, and FDG-PET/CT were interpreted separately to determine the performance of each imaging modality. Histopathology served as reference in all patients, and in further 60 patients, a benign lesion was verified at follow-up (mean follow-up of 1,040 days). RESULTS: Histology revealed malignant lung tumors in 216 of 276 patients. With PET and PET/CT, a significantly lower number of lesions were classified as equivocal compared to CT alone (p < 0.001). Assuming that equivocal lesions are benign, performance of diagnostic tests was as follows: sensitivity, specificity, and accuracy for CT was 94, 75, and 90%, for PET 97, 83, and 94% (p = 0.021), and for PET/CT 96, 87, and 94% (p = 0.010). Assuming that equivocal lesions are malignant, sensitivity, specificity, and accuracy for CT was 99, 37, and 86%, for PET 99, 77, and 94% (p < 0.001), and for PET/CT 98, 68, and 92% (p = 0.002). PET and PET/CT showed the highest concordance (K = 0.912; confidence interval 0.866-0.958). In lesions less than or equal to 3 cm, there was a significant difference in the performance of PET alone and multidetector row CT as well as PET/CT and multidetector row CT (p = 0.007), irrespective if equivocal findings were judged as malignant or benign. CONCLUSION: For differentiation of benign from malignant lung lesions, integrated FDG-PET/CT imaging was significantly more accurate than CT but not FDG-PET. The addition of metabolic imaging (FDG-PET) to morphological imaging (CT) leads to an increase in specificity and significantly reduced equivocal findings and is therefore recommended to further specify newly diagnosed lung lesions.
Authors: Mylene T Truong; Jeremy J Erasmus; Homer A Macapinlac; Edith M Marom; Osama Mawlawi; Gregory W Gladish; Bradley S Sabloff; John F Bruzzi; Reginald F Munden Journal: J Comput Assist Tomogr Date: 2005 Mar-Apr Impact factor: 1.826
Authors: R M Pieterman; J W van Putten; J J Meuzelaar; E L Mooyaart; W Vaalburg; G H Koëter; V Fidler; J Pruim; H J Groen Journal: N Engl J Med Date: 2000-07-27 Impact factor: 91.245
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Authors: S Pauls; A K Buck; K Hohl; G Halter; M Hetzel; N M Blumstein; F M Mottaghy; G Glatting; S Krüger; L Sunder-Plassmann; P Möller; V Hombach; H-J Brambs; S N Reske Journal: Nuklearmedizin Date: 2007 Impact factor: 1.379
Authors: Didier Lardinois; Walter Weder; Thomas F Hany; Ehab M Kamel; Stephan Korom; Burkhardt Seifert; Gustav K von Schulthess; Hans C Steinert Journal: N Engl J Med Date: 2003-06-19 Impact factor: 91.245
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
Authors: K Strobel; U E Exner; K D M Stumpe; T F Hany; B Bode; K Mende; P Veit-Haibach; G K von Schulthess; Juerg Hodler Journal: Eur J Nucl Med Mol Imaging Date: 2008-08-20 Impact factor: 9.236