Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management
BACKGROUND: Positron emission tomography (PET), a new noninvasive imaging modality, utilizing 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG), has demonstrated increased FDG uptake in lung tumors. OBJECTIVE: To determine the diagnostic efficacy of PET-FDG imaging in differentiating benign from malignant sol...
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| Veröffentlicht in: | Chest 1993-10, Vol.104 (4), p.997-1002 |
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| creator | DEWAN, N. A GUPTA, N. C REDEPENNING, L. S PHALEN, J. J FRICK, M. P |
| description | BACKGROUND: Positron emission tomography (PET), a new noninvasive imaging modality, utilizing 2-[F-18]-fluoro-2-deoxy-D-glucose
(FDG), has demonstrated increased FDG uptake in lung tumors. OBJECTIVE: To determine the diagnostic efficacy of PET-FDG imaging
in differentiating benign from malignant solitary pulmonary nodules. PATIENT SELECTION: A prospective study of 30 patients
who presented with indeterminate solitary pulmonary nodules less than 3 cm in size based on chest radiograph and computed
tomographic (CT) scan. SETTING: Two tertiary care medical centers in Omaha, Neb: Creighton University Medical Center and the
Omaha Veterans Administration Medical Center. MEASUREMENTS: Positron emission tomographic imaging of the lung was performed
1 h after intravenous injection of 10 mCi of F-18-FDG. Qualitative analysis of the images was performed independently by two
observers by visual identification of the areas of increased FDG uptake in the lung nodules. Semiquantitative analysis was
performed using computation of differential uptake ratio (DUR). Histologic specimens were obtained in 29 patients (thoracotomy
20, transthoracic needle aspiration biopsy 8, bronchoscopy 1). RESULTS: Positron emission tomographic imaging correctly identified
27 of 30 pulmonary nodules. Diagnostic accuracy was high with sensitivity of 95 percent and specificity of 80 percent. The
positive and negative predictive value of PET imaging for solitary pulmonary nodules was 90 percent and 89 percent, respectively.
The DUR values were significantly higher for malignant nodules (mean +/- SD, 5.55 +/- 2.79) than benign nodules (mean +/-
SD, 0.95 +/- 0.99) (p < 0.001). There was one false-negative result in a patient with a 1-cm nodule identified as a scar adenocarcinoma.
There were two false-positive cases and both had caseating granulomas with active inflammation and Histoplasma organisms.
CONCLUSION: PET-FDG imaging of the lung, a new noninvasive diagnostic test, has a high degree of accuracy in differentiating
benign from malignant pulmonary nodules. PET-FDG imaging could complement CT scanning in the evaluation and treatment of patients
with solitary pulmonary nodules. |
| doi_str_mv | 10.1378/chest.104.4.997 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_pasca</sourceid><recordid>TN_cdi_pubmed_primary_8404239</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>8404239</sourcerecordid><originalsourceid>FETCH-LOGICAL-h244t-49830c05dfcf47b2422c22bd9b174f6e6ffe3924fbd232092477b027b830eddb3</originalsourceid><addsrcrecordid>eNo9kb1PwzAQxS0EKqUwMyF5YE3q2G5cj6gfgFSJDmWOHMdOXDl2iRNQ_3tcWjHdO73fnXT3AHjMUJoRNp_KRoU-zRBNaco5uwLjjJMsITNKrsEYoQwnJOf4FtyFsEexz3g-AqM5RRQTPgZfSyNq50NvJFRaGynkEXoNt6tdsl6-QtOK2rgaGgeDt6YX3REeBtt6d1LOV4NVIYVb3yvXG2Fh56060epb2EH0xjsoXAVb4USt2gjdgxstbFAPlzoBn-vVbvGWbD5e3xcvm6TBlPYJ5XOCJJpVWmrKSkwxlhiXFS8zRnWucq0V4ZjqssIEo6gYKxFmZRxTVVWSCXg67z0MZauq4tDFW7pjcTk9-s8XXwQprO6Ekyb8Y4RxMuN5xKZnrDF182M6VYRWWBuXkuLv-Xs_dE7YGEFBixgB-QVH7XqZ</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>DEWAN, N. A ; GUPTA, N. C ; REDEPENNING, L. S ; PHALEN, J. J ; FRICK, M. P</creator><creatorcontrib>DEWAN, N. A ; GUPTA, N. C ; REDEPENNING, L. S ; PHALEN, J. J ; FRICK, M. P</creatorcontrib><description>BACKGROUND: Positron emission tomography (PET), a new noninvasive imaging modality, utilizing 2-[F-18]-fluoro-2-deoxy-D-glucose
(FDG), has demonstrated increased FDG uptake in lung tumors. OBJECTIVE: To determine the diagnostic efficacy of PET-FDG imaging
in differentiating benign from malignant solitary pulmonary nodules. PATIENT SELECTION: A prospective study of 30 patients
who presented with indeterminate solitary pulmonary nodules less than 3 cm in size based on chest radiograph and computed
tomographic (CT) scan. SETTING: Two tertiary care medical centers in Omaha, Neb: Creighton University Medical Center and the
Omaha Veterans Administration Medical Center. MEASUREMENTS: Positron emission tomographic imaging of the lung was performed
1 h after intravenous injection of 10 mCi of F-18-FDG. Qualitative analysis of the images was performed independently by two
observers by visual identification of the areas of increased FDG uptake in the lung nodules. Semiquantitative analysis was
performed using computation of differential uptake ratio (DUR). Histologic specimens were obtained in 29 patients (thoracotomy
20, transthoracic needle aspiration biopsy 8, bronchoscopy 1). RESULTS: Positron emission tomographic imaging correctly identified
27 of 30 pulmonary nodules. Diagnostic accuracy was high with sensitivity of 95 percent and specificity of 80 percent. The
positive and negative predictive value of PET imaging for solitary pulmonary nodules was 90 percent and 89 percent, respectively.
The DUR values were significantly higher for malignant nodules (mean +/- SD, 5.55 +/- 2.79) than benign nodules (mean +/-
SD, 0.95 +/- 0.99) (p < 0.001). There was one false-negative result in a patient with a 1-cm nodule identified as a scar adenocarcinoma.
There were two false-positive cases and both had caseating granulomas with active inflammation and Histoplasma organisms.
CONCLUSION: PET-FDG imaging of the lung, a new noninvasive diagnostic test, has a high degree of accuracy in differentiating
benign from malignant pulmonary nodules. PET-FDG imaging could complement CT scanning in the evaluation and treatment of patients
with solitary pulmonary nodules.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.104.4.997</identifier><identifier>PMID: 8404239</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: American College of Chest Physicians</publisher><subject>Aged ; Biological and medical sciences ; Deoxyglucose - analogs & derivatives ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung - diagnostic imaging ; Lung - pathology ; Lung Neoplasms - diagnosis ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - epidemiology ; Male ; Medical sciences ; Middle Aged ; Pneumology ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Solitary Pulmonary Nodule - diagnosis ; Solitary Pulmonary Nodule - diagnostic imaging ; Solitary Pulmonary Nodule - epidemiology ; Tomography, Emission-Computed ; Tumors of the respiratory system and mediastinum</subject><ispartof>Chest, 1993-10, Vol.104 (4), p.997-1002</ispartof><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3793596$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8404239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DEWAN, N. A</creatorcontrib><creatorcontrib>GUPTA, N. C</creatorcontrib><creatorcontrib>REDEPENNING, L. S</creatorcontrib><creatorcontrib>PHALEN, J. J</creatorcontrib><creatorcontrib>FRICK, M. P</creatorcontrib><title>Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management</title><title>Chest</title><addtitle>Chest</addtitle><description>BACKGROUND: Positron emission tomography (PET), a new noninvasive imaging modality, utilizing 2-[F-18]-fluoro-2-deoxy-D-glucose
(FDG), has demonstrated increased FDG uptake in lung tumors. OBJECTIVE: To determine the diagnostic efficacy of PET-FDG imaging
in differentiating benign from malignant solitary pulmonary nodules. PATIENT SELECTION: A prospective study of 30 patients
who presented with indeterminate solitary pulmonary nodules less than 3 cm in size based on chest radiograph and computed
tomographic (CT) scan. SETTING: Two tertiary care medical centers in Omaha, Neb: Creighton University Medical Center and the
Omaha Veterans Administration Medical Center. MEASUREMENTS: Positron emission tomographic imaging of the lung was performed
1 h after intravenous injection of 10 mCi of F-18-FDG. Qualitative analysis of the images was performed independently by two
observers by visual identification of the areas of increased FDG uptake in the lung nodules. Semiquantitative analysis was
performed using computation of differential uptake ratio (DUR). Histologic specimens were obtained in 29 patients (thoracotomy
20, transthoracic needle aspiration biopsy 8, bronchoscopy 1). RESULTS: Positron emission tomographic imaging correctly identified
27 of 30 pulmonary nodules. Diagnostic accuracy was high with sensitivity of 95 percent and specificity of 80 percent. The
positive and negative predictive value of PET imaging for solitary pulmonary nodules was 90 percent and 89 percent, respectively.
The DUR values were significantly higher for malignant nodules (mean +/- SD, 5.55 +/- 2.79) than benign nodules (mean +/-
SD, 0.95 +/- 0.99) (p < 0.001). There was one false-negative result in a patient with a 1-cm nodule identified as a scar adenocarcinoma.
There were two false-positive cases and both had caseating granulomas with active inflammation and Histoplasma organisms.
CONCLUSION: PET-FDG imaging of the lung, a new noninvasive diagnostic test, has a high degree of accuracy in differentiating
benign from malignant pulmonary nodules. PET-FDG imaging could complement CT scanning in the evaluation and treatment of patients
with solitary pulmonary nodules.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Deoxyglucose - analogs & derivatives</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - pathology</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumology</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Solitary Pulmonary Nodule - diagnosis</subject><subject>Solitary Pulmonary Nodule - diagnostic imaging</subject><subject>Solitary Pulmonary Nodule - epidemiology</subject><subject>Tomography, Emission-Computed</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kb1PwzAQxS0EKqUwMyF5YE3q2G5cj6gfgFSJDmWOHMdOXDl2iRNQ_3tcWjHdO73fnXT3AHjMUJoRNp_KRoU-zRBNaco5uwLjjJMsITNKrsEYoQwnJOf4FtyFsEexz3g-AqM5RRQTPgZfSyNq50NvJFRaGynkEXoNt6tdsl6-QtOK2rgaGgeDt6YX3REeBtt6d1LOV4NVIYVb3yvXG2Fh56060epb2EH0xjsoXAVb4USt2gjdgxstbFAPlzoBn-vVbvGWbD5e3xcvm6TBlPYJ5XOCJJpVWmrKSkwxlhiXFS8zRnWucq0V4ZjqssIEo6gYKxFmZRxTVVWSCXg67z0MZauq4tDFW7pjcTk9-s8XXwQprO6Ekyb8Y4RxMuN5xKZnrDF182M6VYRWWBuXkuLv-Xs_dE7YGEFBixgB-QVH7XqZ</recordid><startdate>19931001</startdate><enddate>19931001</enddate><creator>DEWAN, N. A</creator><creator>GUPTA, N. C</creator><creator>REDEPENNING, L. S</creator><creator>PHALEN, J. J</creator><creator>FRICK, M. P</creator><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>19931001</creationdate><title>Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management</title><author>DEWAN, N. A ; GUPTA, N. C ; REDEPENNING, L. S ; PHALEN, J. J ; FRICK, M. P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h244t-49830c05dfcf47b2422c22bd9b174f6e6ffe3924fbd232092477b027b830eddb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Deoxyglucose - analogs & derivatives</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - pathology</topic><topic>Lung Neoplasms - diagnosis</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumology</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Solitary Pulmonary Nodule - diagnosis</topic><topic>Solitary Pulmonary Nodule - diagnostic imaging</topic><topic>Solitary Pulmonary Nodule - epidemiology</topic><topic>Tomography, Emission-Computed</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DEWAN, N. A</creatorcontrib><creatorcontrib>GUPTA, N. C</creatorcontrib><creatorcontrib>REDEPENNING, L. S</creatorcontrib><creatorcontrib>PHALEN, J. J</creatorcontrib><creatorcontrib>FRICK, M. P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DEWAN, N. A</au><au>GUPTA, N. C</au><au>REDEPENNING, L. S</au><au>PHALEN, J. J</au><au>FRICK, M. P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1993-10-01</date><risdate>1993</risdate><volume>104</volume><issue>4</issue><spage>997</spage><epage>1002</epage><pages>997-1002</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>BACKGROUND: Positron emission tomography (PET), a new noninvasive imaging modality, utilizing 2-[F-18]-fluoro-2-deoxy-D-glucose
(FDG), has demonstrated increased FDG uptake in lung tumors. OBJECTIVE: To determine the diagnostic efficacy of PET-FDG imaging
in differentiating benign from malignant solitary pulmonary nodules. PATIENT SELECTION: A prospective study of 30 patients
who presented with indeterminate solitary pulmonary nodules less than 3 cm in size based on chest radiograph and computed
tomographic (CT) scan. SETTING: Two tertiary care medical centers in Omaha, Neb: Creighton University Medical Center and the
Omaha Veterans Administration Medical Center. MEASUREMENTS: Positron emission tomographic imaging of the lung was performed
1 h after intravenous injection of 10 mCi of F-18-FDG. Qualitative analysis of the images was performed independently by two
observers by visual identification of the areas of increased FDG uptake in the lung nodules. Semiquantitative analysis was
performed using computation of differential uptake ratio (DUR). Histologic specimens were obtained in 29 patients (thoracotomy
20, transthoracic needle aspiration biopsy 8, bronchoscopy 1). RESULTS: Positron emission tomographic imaging correctly identified
27 of 30 pulmonary nodules. Diagnostic accuracy was high with sensitivity of 95 percent and specificity of 80 percent. The
positive and negative predictive value of PET imaging for solitary pulmonary nodules was 90 percent and 89 percent, respectively.
The DUR values were significantly higher for malignant nodules (mean +/- SD, 5.55 +/- 2.79) than benign nodules (mean +/-
SD, 0.95 +/- 0.99) (p < 0.001). There was one false-negative result in a patient with a 1-cm nodule identified as a scar adenocarcinoma.
There were two false-positive cases and both had caseating granulomas with active inflammation and Histoplasma organisms.
CONCLUSION: PET-FDG imaging of the lung, a new noninvasive diagnostic test, has a high degree of accuracy in differentiating
benign from malignant pulmonary nodules. PET-FDG imaging could complement CT scanning in the evaluation and treatment of patients
with solitary pulmonary nodules.</abstract><cop>Northbrook, IL</cop><pub>American College of Chest Physicians</pub><pmid>8404239</pmid><doi>10.1378/chest.104.4.997</doi><tpages>6</tpages></addata></record> |
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| ispartof | Chest, 1993-10, Vol.104 (4), p.997-1002 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Biological and medical sciences Deoxyglucose - analogs & derivatives Diagnosis, Differential Female Fluorodeoxyglucose F18 Humans Lung - diagnostic imaging Lung - pathology Lung Neoplasms - diagnosis Lung Neoplasms - diagnostic imaging Lung Neoplasms - epidemiology Male Medical sciences Middle Aged Pneumology Predictive Value of Tests Prospective Studies Sensitivity and Specificity Solitary Pulmonary Nodule - diagnosis Solitary Pulmonary Nodule - diagnostic imaging Solitary Pulmonary Nodule - epidemiology Tomography, Emission-Computed Tumors of the respiratory system and mediastinum |
| title | Diagnostic efficacy of PET-FDG imaging in solitary pulmonary nodules. Potential role in evaluation and management |
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