OBJECTIVE: This study prospectively evaluates the serial change of FDG uptake and its diagnostic value in malignant versus benign lung lesions in patients with suspected lung cancer. PATIENTS AND METHODS: Patients with suspected lung malignancy underwent whole-body FDG PET/CT at 1, 2, and 3 hours after an IV injection of F-FDG. The SUVs of FDG in lung nodules and hilar/mediastinal nodes at each time point were correlated with biopsy/surgical pathologic findings. RESULTS: There were a total of 45 malignant lesions and 80 benign lesions from 43 patients with pathologic diagnosis that were included for analysis. The SUVmax had an average of 25.5% increase in all tumor-positive lesions from 1 to 2 hours (vs 1.6% decrease in all tumor-negative lesions, P < 0.0001) and an average of 39.1% increase from 1 to 3 hours (vs 4.5% increase in all tumor-negative lesions, P < 0.0001). The receiver operating characteristic analysis showed that the 2-hour and 3-hour SUVmax had similar area under the curve and outperformed the SUVmax on the 1-hour initial imaging or retention index (RI). The optimal cutoff values to differentiate malignancy from benign lesions were 3.24 for 1-hour SUVmax, 3.67 for 2-hour SUVmax, and 4.21 for 3-hour SUVmax, with 11.6% for 1- to 2-hour RI and 23.9% for 1- to 3-hour RI. The 3-hour delayed SUVmax of 4.21 provided the best overall performance (accuracy of 88.8%). The analysis of the lesion-to-background ratio revealed that delayed imaging improved the image quality significantly, leading to much easier detection of either malignant or benign lesions. CONCLUSIONS: Multiple time point FDG PET/CT imaging moderately improves the diagnostic accuracy of lung cancer and significantly improves the image quality.
OBJECTIVE: This study prospectively evaluates the serial change of FDG uptake and its diagnostic value in malignant versus benign lung lesions in patients with suspected lung cancer. PATIENTS AND METHODS: Patients with suspected lung malignancy underwent whole-body FDG PET/CT at 1, 2, and 3 hours after an IV injection of F-FDG. The SUVs of FDG in lung nodules and hilar/mediastinal nodes at each time point were correlated with biopsy/surgical pathologic findings. RESULTS: There were a total of 45 malignant lesions and 80 benign lesions from 43 patients with pathologic diagnosis that were included for analysis. The SUVmax had an average of 25.5% increase in all tumor-positive lesions from 1 to 2 hours (vs 1.6% decrease in all tumor-negative lesions, P < 0.0001) and an average of 39.1% increase from 1 to 3 hours (vs 4.5% increase in all tumor-negative lesions, P < 0.0001). The receiver operating characteristic analysis showed that the 2-hour and 3-hour SUVmax had similar area under the curve and outperformed the SUVmax on the 1-hour initial imaging or retention index (RI). The optimal cutoff values to differentiate malignancy from benign lesions were 3.24 for 1-hour SUVmax, 3.67 for 2-hour SUVmax, and 4.21 for 3-hour SUVmax, with 11.6% for 1- to 2-hour RI and 23.9% for 1- to 3-hour RI. The 3-hour delayed SUVmax of 4.21 provided the best overall performance (accuracy of 88.8%). The analysis of the lesion-to-background ratio revealed that delayed imaging improved the image quality significantly, leading to much easier detection of either malignant or benign lesions. CONCLUSIONS: Multiple time point FDG PET/CT imaging moderately improves the diagnostic accuracy of lung cancer and significantly improves the image quality.
Authors: Jan H Geismar; Paul Stolzmann; Bert-Ram Sah; Irene A Burger; Burkhardt Seifert; Gaspar Delso; Gustav K von Schulthess; Patrick Veit-Haibach; Lars Husmann Journal: Acta Radiol Open Date: 2015-01-29
Authors: Marius E Mayerhoefer; Chiara Giraudo; Daniela Senn; Markus Hartenbach; Michael Weber; Ivo Rausch; Barbara Kiesewetter; Christian J Herold; Marcus Hacker; Matthias Pones; Ingrid Simonitsch-Klupp; Leonhard Müllauer; Werner Dolak; Julius Lukas; Markus Raderer Journal: Clin Nucl Med Date: 2016-02 Impact factor: 7.794