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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Bradley, A. Articles by Westphal, S. PubMed Articles by Bradley, A. Articles by Westphal, S.

Are low 18F-FDG PET standardized uptake values predictive of benign pulmonary lesions?

¹ Nuclear Medicine Technology Program, Indiana U, Indianapolis, Indiana; ² Radiology Dept., Indiana U Hospital, Indianapolis, Indiana

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Objectives: Pulmonary nodules are often difficult to biopsy for diagnosis and results are not always accurate. Positron Emission Tomography (PET) scans using the radioactive tracer Fluorodeoxyglucose (FDG) have become a new tool in assessing risk of malignancy in these nodules. Current literature has indicated a SUV cutoff of 2.5 as the upper limit for benign conditions. If a scan could consistently discriminate between benign and malignant conditions, the need for further diagnostic testing and patient discomfort could be eliminated.

Methods: During the study period, we identified patients who had been referred for indeterminate pulmonary nodules on chest x-ray or Computed Tomography (CT) and were scanned using FDG-PET. Data were reviewed by staff radiologists. Data included the assessment of SUV as well as a visual impression characterized by low, moderate or high probability of malignancy, inflammation, infectious process, or indeterminate diagnosis. FDG-PET SUV results and, separately, visual results were compared retrospectively with histology and follow-up.

Results: Thirty nodules were malignant and 30 were benign. Four nodules were still considered indeterminate after fine needle aspiration (FNA) biopsy. SUV indicated a sensitivity of 70% and specificity of 78% for detection of benign conditions with a negative predictive value of 75%. Visual analysis scored higher with a sensitivity and specificity of 90.3% and 86.6% respectively, and a negative predictive value of 86.2%.

Conclusions: FDG-PET SUV is a helpful tool but cannot rule out the possibility of false negatives. Greater accuracy by radiologist readers means that PET should still be utilized as a preliminary step prior to more invasive procedures.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Bradley, A. Articles by Westphal, S. PubMed Articles by Bradley, A. Articles by Westphal, S.