The value of 18F-FDG-PET/CT in the diagnosis of solitary pulmonary nodules

Li, Zhenzhen; Huang, Ya-Liang; Song, Hong-Jun; Wang, Youjuan; Huang, Yan

doi:10.1097/md.0000000000010130

Cited by 32 publications

(32 citation statements)

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“…From the comprehensive computer literature search from PubMed/MEDLINE and Cochrane Library databases, 17 meta-analyses were selected and retrieved in full-text version [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. e characteristics of the selected articles are summarized and presented in Table 1 and summarized as follows.…”

Section: Resultsmentioning

confidence: 99%

“…Characterizing SPNs detected incidentally or, as is the case more recently, on CT screening for LC, is a major public health issue. In the last decade, a robust evidence has been produced on the use of single time point (STP) 18 F-FDG PET or PET/CT in the characterization of SPNs [5][6][7][8][9][10][11]. Two examples of 18 F-FDG PET/CT images in the characterization of SPNs are shown in Figure 1.…”

Section: Characterization Of Solitary Pulmonary Nodules With Singlementioning

confidence: 99%

“…Contrast Media & Molecular Imaging Another meta-analysis on the same topic [8] reported a pooled sensitivity of 89% and a pooled specificity of 70% for the diagnosis of malignant SPNs by 18 F-FDG PET/CT. e authors concluded that this method cannot replace the "gold standard" pathology by resection or percutaneous biopsy and larger studies are required for further evaluation.…”

Section: Characterization Of Solitary Pulmonary Nodules With Singlementioning

confidence: 99%

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Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses

Lococo

Muoio

Chiappetta

et al. 2020

Contrast Media & Molecular Imaging

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Purpose. Several meta-analyses have reported data about the diagnostic performance of positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) with different radiotracers in patients with suspicious lung cancer (LC) or pleural tumours (PT). This review article aims at providing an overview on the recent evidence-based data in this setting. Methods. A comprehensive literature search of meta-analyses published in PubMed/MEDLINE and Cochrane Library database from January 2010 through March 2020 about the diagnostic performance of PET or PET/CT with different radiotracers in patients with suspicious LC or PT was performed. This combination of keywords was used: (A) “PET” OR “positron emission tomography” AND (B) “lung” OR “pulmonary” OR “pleur∗” AND (C) meta-analysis. Only meta-analyses on PET or PET/CT in patients with suspicious LC or PT were selected. Results. We have summarized the diagnostic performance of PET or PET/CT with fluorine-18 fluorodeoxyglucose (18F-FDG) and other radiotracers taking into account 17 meta-analyses. Evidence-based data demonstrated a good diagnostic performance of 18F-FDG PET or PET/CT for the characterization of solitary pulmonary nodules (SPNs) or pleural lesions with overall higher sensitivity than specificity. Evidence-based data do not support the routine use of dual time point (DTP) 18F-FDG PET/CT or fluorine-18 fluorothymidine (18F-FLT) PET/CT in the differential diagnosis of SPNs. Even if 18F-FDG PET/CT has high sensitivity and specificity as a selective screening modality for LC, its role in this setting remains unknown. Conclusions. Evidence-based data about the diagnostic performance of PET/CT with different radiotracers for suspicious LC or PT are increasing, with good diagnostic performance of 18F-FDG PET/CT. More prospective multicenter studies and cost-effectiveness analyses are warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Characterization Of Solitary Pulmonary Nodules With Singlementioning

confidence: 99%

Section: Characterization Of Solitary Pulmonary Nodules With Singlementioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses

Lococo

Muoio

Chiappetta

et al. 2020

Contrast Media & Molecular Imaging

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“…Currently, the diagnosis of pulmonary nodules also includes positron emission tomography (PET) with 18-uorodeoxyglucose (FDG), percutaneous needle aspiration biopsy, and transbronchic needle biopsy. Since 18F-FDG-PET/CT has insu cient sensitivity and speci city for the diagnosis of malignant pulmonary nodules, it cannot replace the "gold standard" pathology method based on resection or percutaneous biopsy [19]. Percutaneous needle biopsy and transbronchial needle biopsy are also very useful procedures for the diagnosis of malignant pulmonary nodules.…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Hook-Wire Localization of Malignant Pulmonary Nodules for Video Assisted Thoracoscopic Surgery

Zhang

Liu

Yimin

et al. 2020

Preprint

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Objectives: Video assisted thoracoscopic surgery (VATS) can currently be used to diagnose and treat pulmonary nodules. However, intraoperative location of pulmonary nodules in VATS is challenging due to their small diameter and deep location in the pulmonary parenchyma. The purpose of this study was to report the clinical safety and effectiveness of CT-guided hook-wire for preoperative localization of malignant pulmonary nodules smaller than 1 cm in diameter.Methods: From February 2017 to January 2018, we collected the data of 80 patients with malignant pulmonary nodules less than 1 cm in diameter who underwent CT-guided hook-wire preoperative localization and VATS surgery. The effectiveness of preoperative localization was evaluated based on surgical duration, success rate of VATS surgery, and localization-related complications.Results: The diameter of pulmonary nodules were 0.85 ± 0.17 mm with a distance to the pleural surface of 19.66 ± 14.10 mm. The length of the hook-wire in the lung parenchyma was 29.17 ± 13.14 mm and hook-wire dislodgement occurred in 2 patients. Complications included 27 cases of minor pneumothorax and 18 cases of mild parenchymal hemorrhage. A significant correlation was observed between the length of the hook-wire in the lung parenchyma and mild parenchymal hemorrhage (P = 0.044). The average time of hook-wire localization was 9.0 ± 2.6 min and the average operation time for VATS was 89.02 ± 23.35 min without conversion thoracotomy.Conclusions: CT-guided hook-wire localization of the lesion during VATS resection is safe for malignant pulmonary nodules with diameter less than 1 cm.

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“…Solitary pulmonary nodules, defined as distinct focal pulmonary lesions ≤ 30 mm, are a relatively common finding on chest CT and present a significant opportunity to improve patient outcomes as early diagnosis of lung cancer results in excellent survival rates following surgical resection [1]. However, not all SPNs are due to lung cancer with rates of malignancy ranging from 3% in screening detected nodules to 60% in clinically detected nodules [2][3][4][5]. The accurate characterisation of SPNs is an on-going diagnostic challenge with significant associated health costs [6].…”

Section: Introductionmentioning

confidence: 99%

Impact of solitary pulmonary nodule size on qualitative and quantitative assessment using 18F-fluorodeoxyglucose PET/CT: the SPUTNIK trial

Weir‐McCall

Harris

Miles

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose To compare qualitative and semi-quantitative PET/CT criteria, and the impact of nodule size on the diagnosis of solitary pulmonary nodules in a prospective multicentre trial. Methods Patients with an SPN on CT ≥ 8 and ≤ 30 mm were recruited to the SPUTNIK trial at 16 sites accredited by the UK PET Core Lab. Qualitative assessment used a five-point ordinal PET-grade compared to the mediastinal blood pool, and a combined PET/CT grade using the CT features. Semi-quantitative measures included SUVmax of the nodule, and as an uptake ratio to the mediastinal blood pool (SURBLOOD) or liver (SURLIVER). The endpoints were diagnosis of lung cancer via biopsy/histology or completion of 2-year follow-up. Impact of nodule size was analysed by comparison between nodule size tertiles. Results Three hundred fifty-five participants completed PET/CT and 2-year follow-up, with 59% (209/355) malignant nodules. The AUCs of the three techniques were SUVmax 0.87 (95% CI 0.83;0.91); SURBLOOD 0.87 (95% CI 0.83; 0.91, p = 0.30 versus SUVmax); and SURLIVER 0.87 (95% CI 0.83; 0.91, p = 0.09 vs. SUVmax). The AUCs for all techniques remained stable across size tertiles (p > 0.1 for difference), although the optimal diagnostic threshold varied by size. For nodules < 12 mm, an SUVmax of 1.75 or visual uptake equal to the mediastinum yielded the highest accuracy. For nodules > 16 mm, an SUVmax ≥ 3.6 or visual PET uptake greater than the mediastinum was the most accurate. Conclusion In this multicentre trial, SUVmax was the most accurate technique for the diagnosis of solitary pulmonary nodules. Diagnostic thresholds should be altered according to nodule size. Trial registration ISRCTN - ISRCTN30784948. ClinicalTrials.gov - NCT02013063

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The value of 18F-FDG-PET/CT in the diagnosis of solitary pulmonary nodules

Cited by 32 publications

References 50 publications

Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses

Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses

CT-Guided Hook-Wire Localization of Malignant Pulmonary Nodules for Video Assisted Thoracoscopic Surgery

Impact of solitary pulmonary nodule size on qualitative and quantitative assessment using 18F-fluorodeoxyglucose PET/CT: the SPUTNIK trial

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