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Negative predictive value of a normal PET/CT in patients with solitary pulmonary nodules less than one centimeter.

¹ Nuclear Medicine, Evanston Northwestern Healthcare, Evanston, Illinois

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Objectives: PET/CT scans are widely used for the detection of malignancy. The purpose of this study was to evaluate the sensitivity of PET/CT for Solitary Pulmonary Nodules (SPN) less than one centimeter to determine its negative predictive value in this patient population.

Methods: Data was collected on all patients having a PET/CT scan between May 2005 and May 2007 for the evaluation of a SPN less than 1 cm in diameter. One hundred and twenty patients during the time period fit the above parameters. Ninety patients had a negative PET/CT, meaning there was no uptake of radioisotope in the nodule. Among the ninety patients identified, four were excluded because of the inability to obtain follow up data. The remaining eighty-six patients' clinical data was reviewed to determine the actual negative predictive value of PET/CT in this population.

Results: Of the eighty-six patients, twenty-one patients had follow up CT scans within 6 months of the PET/CT scan showing no change in the size of the nodule and no further follow up. Thirty-six patients had follow up CT scans within 6 months of the PET/CT scan showing nodules that increased in size. These patients have not had a biopsy to date; therefore, malignancy can not be determined. The remaining twenty-nine patients had biopsies. Of these twenty-nine, ten had lesions that were malignant.

Conclusions: The negative predictive value of PET/CT for a SPN less than one centimeter is insufficient to rule out malignancy. In our study 11% of the patients that were negative on PET/CT were confirmed to have malignant disease upon follow up. It is therefore important for all patients with nodules that are smaller than one centimeter and with a negative PET/CT scan to have continued follow up care.

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 Clark Ibarra, P. Articles by Horbenko, P. PubMed Articles by Clark Ibarra, P. Articles by Horbenko, P.