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J Nucl Med. 2008; 49 (Supplement 1):364P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Triple-time point SUV in evaluating solitary pulmonary nodules

Jong-Kang Lee2, Chi-Yung Chang3, Yeu-Sheng Tyan2, Wen-Sheng Huang1 and Ming-Chin Chou4

1 Department of Nuclear Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; 2 Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan; 3 Department of Radiology; 4 Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan

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Objectives: Solitary pulmonary nodules (SPN) sometimes cause diagnostic dilemma in FDG PET. We used a triple-time point SUV to separate malignant from benign SPN.

Methods: Forty-one patients with SPN were enrolled for FDG-PET using a dedicated PET system (Siemens ECAT HR+). Final diagnoses were based on histology or >12 m of CT follow-up. Three PET sets were acquired at 1, 2 and 3 h after 370 MBq FDG injection and were reconstructed using OSEM. Five parameters of maximal SUV and ratios, i.e. SUV1h, SUV2h, SUV3h, SUVR2/1 (SUV2h/SUV1h) and SUVR3/1 (SUV3h/SUV1h) for each SPN were measured. Receiver-operating-characteristic (ROC) curves of the 5 parameters were evaluated using the area under the curves (AUC). Sensitivity, specificity, and positive and negative predictive values were determined at the optimal cutoff points from the ROC curves.

Results: The averaged SUV in malignancy (mean±SD) were 4.60±3.19 at 1h, 5.31±3.44 at 2h, and 5.97±3.59 at 3h. The AUC of SUVR3/1 was 0.98 which is the highest value among the 5 parameters. The optimal cutoff point for SUVR3/1 was 1.05 with 100% sensitivity and 93% specificity, that for SUVR1h was 2.35 with 82% sensitivity and 86% specificity and that for SUVR2/1 was 1.05 with 82% sensitivity and 64% specificity. The slow-growing malignancy tends to have a steady or lower SUV2h compared with SUV1h but always higher SUV3h than SUV1h.

Conclusions: The triple-time point FDG PET provides significantly better discrimination power on SPNs. By setting SUVR3/1 1.05 as the cutoff point yields the highest sensitivity and specificity than that of SUVR1h and SUVR2/1.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Lee, J.-K.
Right arrow Articles by Chou, M.-C.
PubMed
Right arrow Articles by Lee, J.-K.
Right arrow Articles by Chou, M.-C.