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J Nucl Med. 2010; 51 (Supplement 2):1255
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Oncology-Clinical Diagnosis: Lung

Lung Posters

Differentiation between benign and malignant endobronchial obstructive lesions with distal lung collapse using 18F-FDG PET-CT

Arthur Cho1, Ho Jin Cho1, Jae-Hoon Lee1, Hyojung Seo1, Yun Jung Choi1, Won Jun Kang1, Mijin Yun1 and Jong Doo Lee1

1 Yonsei Severance Hospital, Seoul, Republic of Korea

Abstract No. 1255

Objectives: Chest CT is highly sensitive in identification of endobronchial obstructive lesions, but shows lower specificity in differentiating between benign from malignant obstruction. Increased 18F-FDG uptake at the obstruction site should indicate malignancy and low FDG uptake should indicate benign etiology. We propose that careful evaluation of FDG uptake at obstruction site will increase the accuracy in differentiating benign from malignant endobronchial lesions.

Methods: Patients who underwent chest CT and then PET-CT for endobronchial obstructive lesions with distal lung collapse were retrospectively reviewed. Final confirmation was done by fiberoptic bronchoscopy, surgical evaluation or follow up imaging. A chest radiologist retrospectively reviewed the initial chest CT and determined endobronchial lesions to be malignant or benign, and two nuclear medicine physicians reviewed PET-CT for 18F-FDG uptake at the obstruction site. Increased 18F-FDG uptake at the obstruction level was considered to be malignant regardless of 18F-FDG within the atelectatic lung, and standard uptake value (SUV) was obtained.

Results: Among the 84 patients, 62 were pathologically confirmed to have malignant obstruction. A total of 19 of 22 patients were pathologically confirmed to have benign obstruction, and 3 patients were considered benign on follow up CT or 18F-FDG PET/CT. Initial chest CT showed an accuracy of 82.1%, with 12 false positives and three false negatives. 18F-FDG PET had an accuracy of 92.9%, with three false and three false negative. Patients with benign obstruction showed statistically lower FDG uptake than patients with malignant obstruction (benign SUV 2.5±1.0; malignant SUV 12.0±5.9, p<0.001). ROC analysis showed that an SUV cut-off value of 3.4 showed the highest sensitivity of 93.5% and specificity of 90.9%.

Conclusions: 18F-FDG PET/CT shows significant accuracy and specificity compared to chest CT alone in determining benign from malignant lesions in lung collapse patients with endobronchial obstruction





This Article
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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 Cho, A.
Right arrow Articles by Lee, J. D.
PubMed
Right arrow Articles by Cho, A.
Right arrow Articles by Lee, J. D.