Evaluation of various corrections to the standardized uptake value for diagnosis of pulmonary malignancy

Menda, Yusuf; Bushnell, David; Madsen, Mark T.; McLaughlin, Kelley; Kahn, Daniel; Kernstine, Kemp H.

doi:10.1097/00006231-200110000-00004

Cited by 52 publications

(42 citation statements)

References 7 publications

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“…body mass (including fat tissue content, which accumulates less marker) [9,10], blood glucose level (hyperglycaemia may cause increased marker uptake and may lead to unreliable results) [11,12], the time of the examination in relation to administration of the marker [13,14] and the size of lesion [15,16]. Due to the presented limitations, while describing the lesion it is important to take into consideration both visual evaluation and SUV max on PET-CT, and the morphology of the lesion on computed tomography.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of FDG PET/CT in the Evaluation of Solitary Pulmonary Lesions—Own Experience

Opoka¹,

Kunikowska

Podgajny³

et al. 2014

Advances in Respiratory Medicine

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Introduction: In recent years, positron emission tomography (PET) has been increasingly applied in the diagnosis of neoplastic lung diseases. In contrast to conventional imaging studies, PET-CT enables the visualisation of not only the morphology of the suspicious lesion, but also its metabolism. The aim of the present study was to investigate the role of PET-CT in the initial assessment of patients with indeterminate solitary pulmonary lesions. Material and methods: The study was conducted on a group of 82 patients with indeterminate lung nodule diagnosed at the National Institute of Tuberculosis and Lung Diseases in the period from January 2008 to May 2011. CT and PET-CT were performed in all of the patients. Histological or cytological examination of the biopsy specimens obtained from bronchoscopy, mediastinoscopy and intraoperatively were the reference tests. Results: Malignancy was documented in 40 patients (48.8%). Histopathological analysis of all tumours revealed 12 cases of squamous cell carcinoma, 18 cases of adenocarcinoma and 1 case of carcinoid, whereas in 9 patients the diagnosis of "non-small cell cancer not otherwise specified" was made. All lesions except one were of solid character on chest CT. SUV max values exceeding 2.5 were found in 38 cancer patients (true positives, TP). The mean value of SUV max was 9.1 (1-26.8). Forty-two lesions were documented as benign (51.2%). SUV max values equal to or less than 2.5 were found in 37 patients (true negatives, TN). The mean value of SUV max in this group was 1.9 (0.5-8.6). The diagnostic value of PET-CT SUV max exceeding 2.5 in the prediction of neoplastic origin of solitary pulmonary lesions was: sensitivity -95% (95% CI 84-99%), specificity -88% (95% CI 75-95%) and accuracy -91.5% (95% CI 83-96%). Positive predictive value (PPV) was 88.4% (95% CI 76-95%), and negative predictive value (NPV) was 94.8% (95% CI 83-99%). False negative results concerned two patients, with final diagnosis of carcinoid and adenocarcinoma; false positive results were obtained in 5 patients with various inflammatory lesions. Conclusions: In the present study, PET-CT appeared to have high sensitivity (95%), but lower specificity (88%) for predicting the malignant character of solitary pulmonary lesions. Overall diagnostic value of PET-CT SUV max > 2.5 was high -PPV was 88.4%, NPV was 94.8%. In the authors' opinion, the PET-CT value may increase when clinical data as well as other radiological documentation (with retrospective assessment) are taken into consideration.Key words: solitary pulmonary nodule, lung cancer, PET-CT, fluorodeoxyglucose Pneumonol. Alergol. Pol. 2014; 82: 198-205 Streszczenie Wstęp: W ostatnich latach w diagnostyce raka płuca coraz szersze zastosowanie znajduje pozytonowa tomografia emisyjna (PET). W odróżnieniu od klasycznych metod obrazowania PET-CT daje możliwość uwidocznienia nie tylko morfologii, ale także metabolizmu podejrzanego ogniska. Celem pracy była ocena przydatności metody PET-CT w ocenie charakteru zmiany ogniskowej w płucu. Mate...

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Section: Discussionmentioning

confidence: 99%

Accuracy of FDG PET/CT in the Evaluation of Solitary Pulmonary Lesions—Own Experience

Opoka¹,

Kunikowska

Podgajny³

et al. 2014

Advances in Respiratory Medicine

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show abstract

“…This quantity is justified only when the background itself is not subject to For simplicity, several investigators adopted this concept and applied formulations derived by Hoffman and Kessler to clinical data to achieve more accurate assessment of relevant parameters (eg, to correct for brain atrophy) [16]. The technique is used commonly in clinical oncology when a priori information about the tumor (ie, a spherical shape of known size) is available [13,[17][18][19][20]. The approach is limited, however, by the crude approximations involved, and more sophisticated techniques were sought.…”

Section: Recovery Coefficient Methodsmentioning

confidence: 99%

“…The most straightforward approach uses a set of precalculated recovery coefficients for more reliable estimates of the SUV in pulmonary lesions [20,74,75] and breast cancer [76]. The bias affecting estimates of tumor-to-background ratio resulting from the PVE is dependent on lesion size.…”

Section: Clinical and Research Applications Of Partial Volume Correctionmentioning

confidence: 99%

Partial Volume Correction Strategies in PET

et al. 2007

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“…97,98 The bias affecting TBR estimates owing to PVE is lesion size dependent. The generally accepted criterion is that PVC is required if the lesion size is less than 2-3 times the spatial resolution (FWHM) of the imaging system when the parameter of interest is the maximum voxel value within a particular VoI.…”

Section: Oncology Imagingmentioning

confidence: 99%

Correction for Partial Volume Effects in Emission Tomography

Rousset

Zaidi

2006

Quantitative Analysis in Nuclear Medicine Imaging

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Evaluation of various corrections to the standardized uptake value for diagnosis of pulmonary malignancy

Abstract: The accuracy of SUV analysis for malignancy in lung nodules/masses is not improved by correction for blood glucose or tumour size or by normalizing for body surface area or lean body weight instead of body weight.

Cited by 52 publications

References 7 publications

Accuracy of FDG PET/CT in the Evaluation of Solitary Pulmonary Lesions—Own Experience

Accuracy of FDG PET/CT in the Evaluation of Solitary Pulmonary Lesions—Own Experience

Partial Volume Correction Strategies in PET

Correction for Partial Volume Effects in Emission Tomography

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