Evaluation of F-18 fluorodeoxyglucose (FDG) PET scanning for pulmonary nodules less than 3 cm in diameter, with special reference to the CT images
Evaluation of F-18 fluorodeoxyglucose (FDG) PET scanning for pulmonary nodules less than 3 cm in diameter, with special reference to the CT images
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DOI：
10.1016/j.lungcan.2004.01.009
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发表时间：
2004-07-01
期刊：
影响因子：
5.3
通讯作者：
Uno, K
中科院分区：
文献类型：
--
作者：
Nomori, H;Watanabe, K;Uno, K
背景：肺白色结节在CT上大体可分为实性结节和磨玻璃样结节，它们具有不同的生物学性质，在氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）上可引起假阳性或假阴性诊断恶性肿瘤。为了确定PET对肺小结节的有效性，将结节分为实性结节和GGO结节，并将结果与PET扫描数据进行比较。同时评估了PET成像中结节的下限大小。方法：对136例直径小于3cm的非钙化结节进行前瞻性FDG-PET扫描。对每个结节绘制CT密度直方图，分为实性结节和GGO结节。结果：恶性结节81例，良性55例。所有人。20例直径小于1cm的结节（恶性8例，良性12例），无论组织学如何，PET检查均为阴性。116例直径1 ~ 3cm的结节中，恶性73例，良性43例，假阴性15例，假阳性15例，敏感性79%，特异性65%。CT密度直方图显示实性结节101个（恶性63例，良性38例），GGO结节15个（恶性10例，良性5例）。10例GGO图像的恶性结节均为组织学上分化良好的腺癌，其中9例（90%）为PET假阴性，5例（80%）良性结节为局灶性肺炎，气道保存良好，PET假阳性。GGO影像对结节的敏感性和特异性分别为10%和20%，显著低于实体影像对结节的90%和71% （P < 0.001）。结论：CT上小于1cm或显示GGO影像的肺结节不能被PET准确评估。2004爱思唯尔爱尔兰有限公司版权所有。
Background: White pulmonary nodules can be substantially divided into solid and ground-glass opacity (GGO) ones on CT image, they have different biological natures which could cause false positive or false negative to diagnose malignancy on positron emission tomography with fluorodeoxyglucose (FDG-PET). To determine the effectiveness of PET for small pulmonary nodules, the nodules were classified into solid and GGO ones, of which results were compared with the data of PET scans. The lower limit size of nodules for PET imaging was also evaluated. Methods: Prospective FDG-PET scans were undertaken for 136 non-calcified nodules less than 3 cm in diameter. CT density histograms were made for each nodule to classify into solid and GGO ones. Results: Eighty-one nodules were malignant and 55 were benign. All. of the 20 nodules less than 1 cm in diameter (n = 8 in malignant, n = 12 in benign), were negative on PET regardless of the histology. In the 116 nodules 1-3 cm in diameter (n = 73 in malignant, n = 43 in benign), there were 15 false negative and 15 false positive nodules, with a sensitivity of 79% and specificity of 65%. CT density histograms showed 101 solid nodules (n = 63 in malignant, n = 38 in benign) and 15 GGO nodules (n = 10 in malignant, n = 5 in benign). All of the 10 malignant nodules with GGO images were histologically well-differentiated adenocarcinoma and 9 of them (90%) were false negative on PET Four of the 5 (80%) benign nodules with GGO images were focal pneumonia with well-preserved air spaces, causing false positive on PET. Sensitivity and specificity for nodules with GGO images were 10 and 20%, respectively, which were significantly lower than 90 and 71% for nodules with solid images (P < 0.001). Conclusion: Pulmonary nodules which are less than 1 cm in size or show GGO images on CT cannot be evaluated accurately by PET. (C) 2004 Elsevier Ireland Ltd. All rights reserved.