Comparison of Quantitatively Analyzed Dynamic Area-Detector CT Using Various Mathematic Methods With FDG PET/CT in Management of Solitary Pulmonary Nodules

Ohno, Yoshiharu; Nishio, Motohiro; Koyama, Hisanobu; Fujisawa, Yasuko; Yoshikawa, Takeshi; Matsumoto, Shinsuke; Sugimura, Kazuro

doi:10.2214/ajr.12.9197

Cited by 35 publications

(86 citation statements)

References 32 publications

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“…Li et al 162 in a similar sized study of 77 nodules confirmed this potential with sensitivities, specificities and accuracies to diagnose malignancy of 91.3–93.5%, 81.8–90.9% and 88.2–92.6%, respectively. More recently, Ohno et al in two prospective comparative studies between perfusion DCE-CT and FDG PET-CT have suggested that perfusion CT is more specific and accurate than FDG PET-CT 163 164. However, in both studies an SUV max cut-off point was used to determine malignancy on FDG-PET-CT with nodule characteristics on the CT component of the examination not obviously used to make this decision.…”

Section: Further Imaging In Management Of Pulmonary Nodulesmentioning

confidence: 99%

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Callister

Baldwin

Akram

et al. 2015

Thorax

743

724

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Section: Further Imaging In Management Of Pulmonary Nodulesmentioning

confidence: 99%

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Callister

Baldwin

Akram

et al. 2015

Thorax

743

724

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“…The average adjusted specificity for studies that used a FDG-PET or FDG-PET/CT in combination with another imaging modality (75%) was similar to studies using only FDG-PET/CT (76%). 38,41-43,53,62,75,79,80,87 …”

Section: Resultsmentioning

confidence: 99%

“…41,43 Two studies used dynamic, 3-dimensional CT scanning. 53,87 Two studies reported using F18-fluorothyminidine in conjunction with FDG. 42,79 One study used a sodium iodide detector 38 and 3 studies created algorithms of staggered PET scans and changes in standard uptake values (dual-time point).…”

Section: Resultsmentioning

confidence: 99%

Accuracy of FDG-PET to Diagnose Lung Cancer in Areas With Infectious Lung Disease

Deppen

Blume

Kensinger

et al. 2014

JAMA

155

119

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Importance Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is recommended for the non-invasive diagnosis of pulmonary nodules suspicious for lung cancer. In populations with endemic infectious lung disease, FDG-PET may not accurately identify malignant lesions. Objective To estimate the diagnostic accuracy of FDG-PET for pulmonary nodules suspicious for lung cancer in regions where infectious lung disease is endemic and compare the test accuracy in regions where infectious lung disease is rare. Data Sources and Study Selection Databases of MEDLINE, EMBASE and the Web of Science were searched from October 1, 2000, through April 28, 2014. Articles reporting information sufficient to calculate sensitivity and specificity of FDG-PET to diagnose lung cancer were included. Only studies that enrolled more than 10 participants with benign and malignant lesions were included. Database searches yielded 1923 articles, of which 257 were assessed for eligibility. Seventy studies were included in the analysis. Studies reported on a total of 8511 nodules; 5105 (60%) were malignant. Data Extraction and Synthesis Abstracts meeting eligibility criteria were collected by a research librarian and reviewed by 2 independent reviewers. Hierarchical summary receiver operating characteristic curves were constructed. A random-effects logistic regression model was used to summarize and assess the effect of endemic infectious lung disease on test performance. Main Outcome and Measures The sensitivity and specificity for FDG-PET test performance. Results Heterogeneity for sensitivity (I2=87%) and specificity (I2=82%) was observed across studies. The pooled (unadjusted) sensitivity was 89% (95% CI, 86%-91%) and specificity was 75% (95% CI, 71%-79%). There was a 16% lower average adjusted specificity in regions with endemic infectious lung disease (61% [95% CI, 49%-72%]) compared with nonendemic regions (77% [95% CI, 73%-80%]). Lower specificity was observed when the analysis was limited to rigorously conducted and well-controlled studies. In general, sensitivity did not change appreciably by endemic infection status, even after adjusting for relevant factors. Conclusions and Relevance The accuracy of FDG-PET for diagnosing lung nodules was extremely heterogeneous. Use of FDG-PET combined with computed tomography was less specific in diagnosing malignancy in populations with endemic infectious lung disease compared with nonendemic regions. These data do not support use of FDG-PET to diagnose lung cancer in endemic areas unless an institution achieves test performance accuracy similar to that found in nonendemic regions.

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“…These include imaging methodologies, such as computer-aided detection (X-ray [22] and CT scan [23][24][25]), computer-aided diagnosis (CAD) (26)(27)(28)(29), volume and mass analysis (30,31), gated PET imaging (32,33), PET imaging using novel radioactive tracers (32,33), novel algorithms to reconstruct CT images allowing lower radiation dose (32-34) (e.g., model-based iterative reconstruction), and procedures such as navigational bronchoscopy and radial ultrasound (17). There is also great potential for novel biomarkers to distinguish benign from malignant nodules and aggressive versus relatively indolent cancers (35,36).…”

Section: Framing Research Questions For Novel Diagnostic Proceduresmentioning

confidence: 99%

An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management

Slatore¹,

Horeweg²,

Jett³

et al. 2015

Am J Respir Crit Care Med

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Comparison of Quantitatively Analyzed Dynamic Area-Detector CT Using Various Mathematic Methods With FDG PET/CT in Management of Solitary Pulmonary Nodules

Abstract: Dynamic area-detector CT analyzed using the dual-input maximum slope method has better potential for the diagnosis of pulmonary nodules than dynamic area-detector CT analyzed using other methods and than PET/CT.

Cited by 35 publications

References 32 publications

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Accuracy of FDG-PET to Diagnose Lung Cancer in Areas With Infectious Lung Disease

An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management

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