| Accuracy of early and delayed FDG PET-CT and of contrast-enhanced CT in the evaluation of lung nodules: a preliminary study on 30 patients. | |
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MedLine Citation:
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PMID: 19579015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The aim of our prospective study was to compare the diagnostic accuracy of early, delayed and dual-time-point positron emission tomography (PET) acquisition with contrast enhanced computed tomography (CT) within a PET-CT examination in the evaluation of pulmonary solitary nodules (SPNs). MATERIALS AND METHODS: Thirty patients were enrolled in the study. All the patients underwent a dual-time-point PET-CT examination. Whole-body PET images were acquired at 50 min after fluorine18-fluorodeoxyglucose ((18)F-FDG) administration (early), followed by a chest acquisition (delayed). Lung nodules with maximum standardised uptake value SUVmax > or =2.5 were considered malignant. SUVmax was calculated on early and delayed images; SUV increasing > or =10% (Delta SUVmax) was considered suggestive of malignancy. Absence of significant lung nodule enhancement (<15 Delta HU) at CT was considered strongly predictive of benignity. For the CT morphological assessment, the irregularity of the shape of each lesion was rated. PET-CT results were related to histological assays and clinical records. Diagnostic accuracy was assessed by area under the receiveroperarting characteristic (ROC) curves analysis. RESULTS: Early and delayed SUVmax of malignant nodules were significantly higher than those of benign disease. Early SUVmax sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 77%, 91%, 79.5% and 66.7%; delayed SUVmax corresponding values were 77%, 66%, 74% and 66%; dual-time-point SUVmax values were 83%, 67%, 75% and 74%; DeltaHU values were 94%, 34%, 67%, 96%; CT morphologic evaluation values were 61%, 46%, 60%, 47%. Area under the curve (AUC) for early SUVmax was 0.79, for delayed SUVmax 0.80, for dual-time-point SUVmax 0.85, for DeltaHU 0.63 and for CT morphologic assessment 0.58. CONCLUSIONS: In our small series of patients, early and delayed SUVmax showed comparable accuracies, whereas morphological and contrast enhanced CT evaluations showed the lowest accuracies. Dual-time-point SUVmax showed the largest AUC. However, dual-time-point SUVmax was most sensitive, whereas single-time-point SUVmax was most specific. |
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Authors:
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O Schillaci; L Travascio; F Bolacchi; F Calabria; C Bruni; C Cicciò; M Guazzaroni; A Orlacchio; G Simonetti |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-07-04 |
Journal Detail:
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Title: La Radiologia medica Volume: 114 ISSN: 1826-6983 ISO Abbreviation: Radiol Med Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-10-02 Completed Date: 2009-12-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0177625 Medline TA: Radiol Med Country: Italy |
Other Details:
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Languages: eng; ita Pagination: 890-906 Citation Subset: IM |
Affiliation:
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Department of Diagnostic Imaging, Molecular Imaging Interventional Radiology and Radiotherapy, University Hospital Tor Vergata, Rome, Italy. orazio.schillaci@uniroma2.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Contrast Media Diagnosis, Differential Female Fluorodeoxyglucose F18 / diagnostic use Humans Lung Neoplasms / radiography*, radionuclide imaging* Male Middle Aged Prospective Studies ROC Curve Radiographic Image Interpretation, Computer-Assisted Radiopharmaceuticals / diagnostic use Sensitivity and Specificity Solitary Pulmonary Nodule / radiography*, radionuclide imaging* Tomography, Emission-Computed / methods* Tomography, X-Ray Computed / methods* Whole Body Imaging |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
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