Accuracy of Positron Emission Tomography for Diagnosis of Pulmonary Nodules and Mass Lesions

Abstract

Positron emission tomography with 18-fluorodeoxyglucose is an accurate noninvasive imaging test for diagnosis of pulmonary nodules and larger mass lesions, although few data exist for nodules smaller than 1 cm in diameter. In current practice, FDG-PET has high sensitivity and intermediate specificity for malignancy.

Diagnostic Performance of Diffusion Weighted Imaging of Malignant and Benign Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography

“…FDG-PET has helped differentiate malignant from benign pulmonary nodules (Lowe et al, 1998;Gould et al, 2001). However, FDG-PET has given false-negative results for well-differentiated pulmonary adenocarcinoma (Higashi et al, 1998;Cheran et al, 2004), or small volumes of metabolically active tumor (Satoh et al, 2011), and false-positive results for inflammatory nodules (Goo et al, 2000;Nomori et al, 2004).…”

“…For assessment of non-solid solitary pulmonary nodules, the cutoff of 1.5 was used for SUVmax (Tsushima et al 2008). Although a meta-analysis (Gould et al, 2001) of studies published between January 1966 and September 2000 in the MEDLINE and CANCERLIT databases showed FGD-PET sensitivity over 90% for malignant pulmonary lesions, the studies mainly looked at solid lung cancers, which are easier to detect by FGD-PET than pure BACs and adenocarcinomas with predominantly BAC features. Now, CT examinations are widely used and make it easy to detect pure BACs, adenocarcinomas with predominantly BAC features, or smaller lung cancers under 10 mm.…”

Detection of Lung Cancer by Sensor Array Analyses of Exhaled Breath

“…Contrast-enhanced spiral computed tomography has a sensitivity of 95 to 100% and a specificity reported between 58 and 93% (35). On the basis of a recent meta-analysis, positron emission tomography has 98.6% sensitivity and 77.8% specificity for identifying a malignant process in patients with pulmonary nodules or masses (36). In contrast to these tests, the analyses of exhaled breath for smellprints characteristic of bronchogenic cancer provide a potentially simple, noninvasive, and inexpensive screening tool.…”

Imaging Evaluation of the Solitary Pulmonary Nodule

“…Qualitative assessments by experienced observers provide equally accurate results as quantitative assessments using SUV values (35). There is a lack of activity confirmed by both the non-attenuation corrected (A) and attenuation corrected (B) images.…”