FDG PET/CT evaluation of pathologically proven pulmonary lesions in an area of high endemic granulomatous disease

Sebro, Ronnie; Aparici, Carina Marí; Hernandez-Pampaloni, Miguel

doi:10.1007/s12149-013-0695-7

Cited by 22 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is plausible to postulate that the main reason for this disparity is the relatively high prevalence of inflammation and TB in our study population, which resulted in a higher false-positive rate and a lower specificity. Our data are consistent with the report by Sebro and coworkers [ 14 ].…”

Section: Discussionsupporting

confidence: 94%

The role of 18F-FDG uptake features in the differential diagnosis of solitary pulmonary lesions with PET/CT

et al. 2015

View full text Add to dashboard Cite

BackgroundThe aim of this study is to evaluate the value of 18F-FDG uptake features in the diagnosis of solitary pulmonary lesions.MethodsOne hundred thirty-nine patients with solitary pulmonary lesions were divided into full uptake, circular uptake, multi-focus uptake, mild uptake, and no-uptake groups according to the uptake features of 18F-FDG in solitary pulmonary lesions. The incidence of benign and malignant lesions and the false-positive and false-negative rates in each group were analyzed. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of the method using 18F-FDG uptake features combined with maximum standard uptake value (SUVmax) (SUV method) in the differential diagnosis of solitary pulmonary lesions were evaluated.ResultsThere were 89 malignant and 50 benign lesions. (1) The malignant incidence of the full uptake group was 84.0 % (63/75), and there were significant differences when compared with the other groups except the circular uptake group (16/23) (all P = 0.0001). The benign incidence of the multi-focus and no-uptake groups was 83.3 % (10/12) and 82.4 % (14/17), respectively, and there were significant differences when compared with the full uptake and the circular uptake groups, respectively (all P < 0.05). The benign incidence of the mild uptake group was 58.3 % (7/12), and there were no significant differences when compared with the others except the full uptake group (all P > 0.05). No statistical significance was found between either two of the no-uptake, mild uptake, and multi-focus uptake groups (all P > 0.05). (2) In cases with SUVmax ≥2.5, the false-positive rate in the multi-focus uptake group was 83.3 % (10/12), which was significantly higher than in the full uptake (12/75) or circular uptake group (7/23) (all P < 0.05). In cases with SUVmax <2.5, the false-negative rates in the mild and no-uptake groups were 41.7 and 17.6 % (P = 0.218). (3) The sensitivity, specificity, accuracy, PPV, and NPV of the method using 18F-FDG uptake features combined with SUVmax and the single SUV method were 88.7 %/91.0 %, 62.0 %/42.0 %, 79.1 %/73.4 %, 80.6 %/73.6 %, and 75.6 %/72.4 %, respectively.ConclusionsThe method using uptake features of 18F-FDG combined with SUVmax can improve the diagnostic specificity and accuracy of solitary pulmonary lesions. The multi-focus uptake feature maybe a benign sign, which still needs more researches to confirm.

show abstract

Section: Discussionsupporting

confidence: 94%

The role of 18F-FDG uptake features in the differential diagnosis of solitary pulmonary lesions with PET/CT

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Ten studies reporting endemic disease had an unadjusted pooled specificity of 54% (95% CI, 37%-69%) 10,11,14,15,24-29 compared with 78% (95% CI, 74%-81%) in the remaining 60 studies. The asymmetry test (using the method by Deeks et al 18 ) did not show evidence of publication bias (Ƥ = .14).…”

Section: Resultsmentioning

confidence: 98%

“…Four of the ten studies were retrospective 10,25,28,29 and 7 studies 10,11,14,15,25,26,29 determined diagnosis with pathology only.…”

Section: Resultsmentioning

confidence: 99%

“…14,24,26-29,32,39,45,46,48,50,52-54,58,60,62,64,67-69,72,74,75,77,80-83,85-88 In comparison, 23 studies with an average or median diameter greater than 2 cm had a slightly higher average adjusted sensitivity (91% [95% CI, 89%-93%]). 10,11,15,25,30,31,34,35,37,41,43,44,55-57,61,63,73,76,78,79,84,86 Specificity of FDG-PET to diagnose lung cancer was not significantly influenced by lesion size (74% for studies with lesions ≤2 cm and 75% for studies with larger average lesion size).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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

Deppen

Blume

Kensinger

et al. 2014

JAMA

155

119

View full text Add to dashboard Cite

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.

show abstract

“…There were 1557 patients with SPNs, 918 malignant and 639 benign. SPNs were diagnosed based on histology in 12 studies [ 15 – 17 , 31 , 33 , 35 , 36 , 39 , 40 , 43 – 45 ] ; in the remaining 9 studies, diagnosis was based on histology or follow-up. All the SPNs were <3 cm.…”

Section: Resultsmentioning

confidence: 99%

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

Huang

Song

et al. 2018

Medicine

View full text Add to dashboard Cite

Background:Solitary pulmonary nodules (SPNs) are common imaging findings. Many studies have indicated that 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) is an accurate test for distinguishing benign and malignant SPNs. The aim of this study was to investigate the value of 18F-FDG-PET/CT in the diagnosis of malignant SPNs.Methods:We systematically searched the PubMed and Embase databases up to March 2017, and published data on sensitivity, specificity, and other measures of diagnostic accuracy of 18F-FDG-PET/CT in the diagnosis of malignant SPNs were meta-analyzed. Statistical analyses were undertaken using Meta-DiSc 1.4 software and Stata version 12.0. The measures of accuracy of 18F-FDG-PET/CT in the diagnosis of malignant SPNs were pooled using random-effects models.Results:A total of 20 publications reporting 21 studies were identified. Pooled results indicated that 18F-FDG-PET/CT showed a diagnostic sensitivity of 0.89 (95% confidence interval [CI], 0.87–0.91) and a specificity of 0.70 (95% CI, 0.66–0.73). The positive likelihood ratio was 3.33 (95% CI, 2.35–4.71) and the negative likelihood ratio was 0.18 (95% CI, 0.13–0.25). The diagnostic odds ratio was 22.43 (95% CI, 12.55–40.07).Conclusions:18F-FDG-PET/CT showed insufficient sensitivity and specificity for diagnosing malignant SPNs; it cannot replace the “gold standard” pathology by resection or percutaneous biopsy. Larger studies are required for further evaluation.

show abstract

FDG PET/CT evaluation of pathologically proven pulmonary lesions in an area of high endemic granulomatous disease

Cited by 22 publications

References 18 publications

The role of 18F-FDG uptake features in the differential diagnosis of solitary pulmonary lesions with PET/CT

The role of 18F-FDG uptake features in the differential diagnosis of solitary pulmonary lesions with PET/CT

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

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

Contact Info

Product

Resources

About