Controlled prospective study of positron emission tomography using the glucose analogue [18F]fluorodeoxyglucose in the evaluation of pulmonary nodules

Präuer, H. W.; Weber, Wolfgang; Römer, Wolfgang; Treumann, Thomas; Ziegler, S.I.; Schwaiger, Markus

doi:10.1046/j.1365-2168.1998.00915.x

Cited by 84 publications

(26 citation statements)

References 24 publications

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“…The sensitivity, specificity, and accuracy of FDG-PET in these studies ranged from 85 to 100% [3,7], 67 to 89% [3,8], and 87 to 92% [3,4,[8][9][10], respectively. In addition, FDG-PET can show a lesion missed on CT and can also reveal the spread of RCC to the lungs [11].…”

Section: Discussionmentioning

confidence: 99%

Differentiating Solitary Pulmonary Metastases in Patients with Renal Cell Carcinomas by <sup>18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography – A Preliminary Report

et al. 2003

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Objective: This preliminary study was to evaluate the characteristics of indeterminate solitary pulmonary lesions in patients with renal cell carcinomas (RCC) using ¹⁸F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Material and Methods: Fifteen patients with RCC were found to have solitary pulmonary lesions with indeterminate chest X-ray and CT findings. Pulmonary metastases were suspected in all cases so whole body surveys with FDG-PET were performed. Results: FDG-PET correctly identified 9 true-positive and 4 true-negative cases. However, FDG-PET failed to interpret 1 false-positive and 1 false-negative case. Standard uptake values (SUV) were used as parameters to differentiate the solitary pulmonary lesions. Using SUV >2.5 as the cutoff to diagnose malignancy, the sensitivity, specificity, and accuracy of FDG-PET were 90, 80, and 87%, respectively. Conclusion: We conclude that FDG-PET is an accurate modality to differentiate solitary pulmonary lesions in patients with RCC.

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Section: Discussionmentioning

confidence: 99%

Differentiating Solitary Pulmonary Metastases in Patients with Renal Cell Carcinomas by <sup>18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography – A Preliminary Report

et al. 2003

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“…Qualitative evaluation of the lesion offers a more objective reporting of the uptake of the lesion [5]. The SUV threshold used by most investigators to differentiate benignity from malignancy in lung lesions is 2.5 [3,6,7,8], above which the lesion is considered to be malignant: (1) (The above equation is from reference [3]. )…”

Section: Introductionmentioning

confidence: 99%

Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET

Hickeson

Yun

Matthies

et al. 2002

European Journal of Nuclear Medicine and Molecular Imaging

162

118

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The purpose of this study was to determine the actual standardized uptake value (SUV) by using the lesion size from computer tomography (CT) scan to correct for resolution and partial volume effects in positron emission tomography (PET) imaging. This retrospective study included 47 patients with lung lesions seen on CT scan whose diagnoses were confirmed by biopsy or by follow up CT scan when the PET result was considered negative for malignancy. Each lesion's FDG uptake was quantified by the SUV using two methods: by measuring the maximum voxel SUV (maxSUV) and by using the lesion's size on CT to calculate the actual SUV (corSUV). Among small lesions (2.0 cm or smaller on CT scan), ten were benign and 17 were malignant. The average maxSUV was 1.43+/-0.77 and 3.02+/-1.74 for benign and malignant lesions respectively. When using an SUV of 2.0 as the cutoff to differentiate benignity and malignancy, the sensitivity, specificity, and accuracy were 65%, 70%, and 67% respectively. When an SUV of 2.5 was used for cutoff, the sensitivity, specificity, and accuracy were 47%, 80%, and 59% respectively. The average corSUV was 1.65+/-1.09 and 5.28+/-2.71 for benign and malignant lesions respectively. Whether an SUV of either 2.0 or 2.5 was used for cutoff, the sensitivity, specificity, and accuracy remained 94%, 70%, and 85% respectively. The only malignant lesion that was falsely considered benign with both methods was a bronchioalveolar carcinoma which did not reveal any elevated uptake of fluorine-18 fluorodeoxyglucose (FDG). Of the large lesions (more than 2.0 cm and less than 6.0 cm), one was benign and 19 were malignant and the corSUV technique did not significantly change the accuracy. It is concluded that measuring the SUV by using the CT size to correct for resolution and partial volume effects offers potential value in differentiating malignant from benign lesions in this population. This approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules.

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“…Limitations of current radiographic techniques for the characterisation of solitary pulmonary nodules (SPNs) [1,2,3] have resulted in substantial interest in metabolic imaging using positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG), in the hope that PET will allow a significant reduction in the use of more costly and invasive methods of differentiating benign from malignant lesions [4,5,6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Solitary pulmonary nodules: accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data

Miles

et al. 2002

Eur J Nucl Med

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This study uses Australian data to confirm the accuracy of dedicated sodium iodide (NaI) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating indeterminate solitary pulmonary nodules (SPNs) and to determine the conditions under which PET could play a cost-effective role in this evaluation. Ninety-two patients from two Australian hospitals in different states underwent FDG-PET for evaluation of an SPN. Observed values for prior probability of malignancy and diagnostic accuracy of PET were applied to previously published decision tree models using published Australian health care costs. The accuracy of FDG-PET was 93% with a sensitivity of 92% and a specificity of 95%. The prior probability of malignancy (0.54), PET sensitivity and PET specificity indicated cost savings per patient of up to EUR 455 (Adollars 774) based on a PET cost of EUR 706 (Adollars 1,200). PET would remain cost-effective for levels of prior probability up to 0.8-0.9 and a PET cost of EUR 736-1,161 (Adollars 1,252-Adollars 1,974). It is concluded that NaI PET is accurate, cost saving and cost-effective for the characterisation of indeterminate pulmonary nodules in Australia. Comparison with previous reports from the United States confirms that FDG-PET can remain cost-effective despite population differences in medical costs, disease prevalence and PET diagnostic performance.

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Controlled prospective study of positron emission tomography using the glucose analogue [18F]fluorodeoxyglucose in the evaluation of pulmonary nodules

Cited by 84 publications

References 24 publications

Differentiating Solitary Pulmonary Metastases in Patients with Renal Cell Carcinomas by <sup>18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography – A Preliminary Report

Differentiating Solitary Pulmonary Metastases in Patients with Renal Cell Carcinomas by <sup>18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography – A Preliminary Report

Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET

Solitary pulmonary nodules: accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data

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