Solitary Pulmonary Nodules Differentiated by Dynamic F-18 FDG PET in a Region with High Prevalence of Granulomatous Disease

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概要

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• This study determined whether dynamic F-18 FDG PET imaging could differentiate benign from malignant solitary pulmonary nodules (SPNs). Histopathologically confirmed SPNs (10–35 mm), 24 malignant and 10 benign, from 34 patients were studied through both dynamic and static F-18 FDG PET imaging of all patients. Volumes of interest (VOIs) were placed over the pulmonary nodules using a 50% maximum pixel value threshold. The arterial input function was estimated from a left ventricle-defined VOI. Based on Patlak analysis, we calculated the net FDG phosphorylation rate (Ki) and glucose metabolic rate (MRGlu) of each nodule. The slope values of the time-activity curves (TACs) of the nodules were also determined. Based on the static PET images, maximum and mean standardized uptake values (SUVmax and SUVmean, respectively) were calculated. Benign and malignant SPNs had significantly different values for SUVmax, SUVmean, Ki, MRGlu, and TAC slope, with area under the receiver operating characteristic curves distinguishing benign from malignant nodules. McNemar's test of marginal homogeneity found all the predictors helpful to detect malignant nodules (all, p > 0.05), and combining Ki and MRGlu, which were generated by dynamic study, yielded a higher specificity of 90%, and a sensitivity of 79%. Among the 10 benign nodules, static SUV imaging correctly classified seven, while dynamic F-18 PET imaging correctly classified nine. Dynamic F-18 FDG PET imaging is valuable in differentiating benign from malignant SPNs, particularly for granulomatous disease.

著者

• Huang Yu-jie

  Department Of Radiation Oncology Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung Un

• WANG Pei-Wen

  Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

• LIU Feng-Yuan

  Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine

• HUANG Yu-Jie

  Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

• HUANG Yu-Erh

  Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine

• LIN Meng-Chih

  Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

• CHEN Chih-Feng

  Department of Radiology, Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine

• LU Hung-I

  Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

• WANG Pei-Wen

  Department of Medicine, Chang Gung Medical College and Chang Gung Memorial Hospital

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