Characterization of solitary pulmonary nodules with 18F-FDG PET/CT relative activity distribution analysis

Zhao, Liang; Li, Tong; Lin, Jie; Tang, Kun; Zheng, Sisi; Li, Wenfeng; Cheng, Dapeng; Yin, Weiwei; Zheng, Xiujuan

doi:10.1007/s00330-015-3592-8

Cited by 17 publications

(20 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, upon consideration of the possibility of false positivity, as mentioned in the current study, frozen section examination should be performed during the surgery before deciding on resection. Recent studies have shown new calculation methods developed to decrease the incorrect assessment of PET/CT and the relative activity distribution (RAD) method, which could be more effective in the distinction of malignant and benign lesions [ 8 ]. In the current study, the mean SUV value of granulomatous lung diseases was calculated as 5.9 and there were lesions with a maximum SUV value of 15.8.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of 18 F-FDG-PET/CT in benign lung diseases

Ergönül

Akçam

Özdil

et al. 2018

kitp

View full text Add to dashboard Cite

IntroductionThere are many diseases which, despite not being malignant, show high metabolic activity and cause false-positive results.AimTo evaluate the results of positron emission tomography (PET) in patients who underwent resection after preliminary diagnosis of malignancy based on fluorodeoxyglucose (FDG) uptake value, in whom the lesions were later classified as pathologically benign.Material and methodsThe analysis included the records of 106 (12.3%) patients out of 862 patients who underwent surgery between January 2012 and December 2015 after being initially diagnosed with malignant lung lesions based on PETCT results, in whom the lesions were later classified as pathologically benign. Diagnoses, PET findings, types of surgery, and demographic data of the patients were recorded.ResultsThe mean age of the patients was 55.5 (26–79) years. The mean diameter and SUVmax of the lesions were 2 ±2.14 (0.5–13) and 3.55 ±4.35 (0–22.2) cm, respectively. The pathology results were analyzed in five different groups. The SUVmax in the hamartoma group was significantly lower than in the other groups (p < 0.001), while the SUVmax in the granulomatous disease group was significantly higher than in the other groups (p < 0.001).ConclusionsThe possibility of false positive PET results must be kept in mind when diagnosing and treating lung cancer. In particular, in the case of suspected granulomatous disease, all available pre- and intraoperative diagnostic procedures must be used.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic value of 18 F-FDG-PET/CT in benign lung diseases

Ergönül

Akçam

Özdil

et al. 2018

kitp

View full text Add to dashboard Cite

show abstract

“…In addition, the diameter of the lesions selected in this study ranged from 8-63 mm (27.7 ± 13.2 mm), which can more fully reflect the metabolic spatial heterogeneity in pulmonary lesions than our previous studies. [11] However, the visual difference of metabolic distribution in small nodules was not obvious due to its small volume, especially for those nodules less than 10 mm in size. However, the diagnostic performance of V-FMSD in different size groups (larger than 10 mm) showed no significance in distinguishing malignant and benign lesions.…”

Section: Discussionmentioning

confidence: 98%

“…Our previous study has confirmed the difference of the relative activity distribution of 18 F-FDG between malignant and benign SPNs. [11] To further simplify the evaluation, the present study used the hilar as a reference to divide the lesions into proximal and distal regions, and visually interpreted the spatial distribution of 18 F-FDG uptake in the two regions of benign and malignant lesions. The results of this study showed that in the malignant lesions, the 18 F-FDG uptake in the proximal region was significantly higher than that of the distal region.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, use of the characterization of SPNs with 18 F-FDG RAD seems to be much more specific than conventional SUV diagnostic method in differentiating malignant and benign SPNs. [11] However, the previous study only analyzed local metabolic distribution on small pulmonary nodules, and the data need to be obtained by complex diameter measurement and calculation. Therefore, the clinical feasibility of 18 F-FDG metabolic spatial distribution (FMSD) in differentiating pulmonary nodules needs a wider range of samples and further simplification.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Visual assessment of 18F-FDG metabolic spatial distribution improves the differential diagnosis of indeterminate pulmonary nodules and masses with high FDG uptake

J¹,

Wang²,

X³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Purpose The aim of this study was to evaluate the value of visual analysis of 18 F-fluorodeoxyglucose ( 18 F-FDG) metabolic spatial distribution (V-FMSD) in diagnosis of indeterminate pulmonary nodules and masses with high 18 F-FDG uptake. Methods A total of 301 patients with indeterminate pulmonary nodules or masses who undergone 18 F-FDG positron emission tomography/computed tomography (PET/ CT) imaging were studied retrospectively. The characteristics of 18 F-FDG metabolic spatial distribution (FMSD) of proximal and distal regions of the lesion were visually analyzed using a 5-point scoring system. The sensitivity, specificity, accuracy and area under receiver operating characteristic curve (AUC) were compared between V-FMSD and conventional PET/CT methods for diagnosis of hypermetabolic indeterminate pulmonary nodules and masses. Results The V-FMSD results showed that 180 (92.8%) malignant lesions’ scores were ≥ 3 and 78 (72.9%) benign lesions’ scores were ≤ 2. It indicated that the FMSD in the proximal region of malignant lesions was significantly higher than that of the distal region, and the FMSD in the proximal region of benign lesions was significantly lower than that of the distal region. The specificity of V-FMSD was 72.9%, which was obviously higher than the maximum standard uptake value (SUVmax) (0%, P < 0.001) and retention index (RI) (26.2%, P < 0.001). The AUC of V-FMSD was 0.886, which was significantly larger than SUVmax (0.626, P < 0.001), RI (0.670, P < 0.001) and PET/CT (0.788, P < 0.05). Conclusions The characteristics of FMSD between pulmonary benign and malignant lesions are different. V-FMSD can be taken as a novel auxiliary marker to improve the diagnostic performance for hypermetabolic indeterminate pulmonary nodules and masses.

show abstract

“…The reason may be that11 C-MET reflects amino acid transport, transmethylation, and protein synthesis in tumor tissue, considered be more tumor specific because its uptake inflammatory cells is low36 .In 2002, Hickeson conducted a retrospective study included 47 patients with lung lesions to determine the actual standardized uptake (SUV) by using the lesion size from CT scan to correct for resolution and partial volume effects in PET imaging. The corSUV was calculated by including the injected dose, patient's weight and time after injection and using lesion's size on CT scan in cm 3 ).They 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, this approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules 34 .Zhao et al37 performed a prospective study of 175 consecutive patients with SPNs, found the capability of relative activity distribution (RAD), a new index of fluorodeoxyglucose F18 ( 18 F-FDG) uptake, which seems to be more specificity and accurate than the typical markers such as maximal standardized uptake value (SUVmax), partial volume corrected SUVmax (corr SUVmax) and the retention index (RI) for differentiating malignant and benign SPNs by 18 F-FDG PET/CT. The reason may be RAD was developed by analysis of metabolic heterogeneity in SPNs.…”

mentioning

confidence: 97%