Likelihood of malignancy in a solitary pulmonary nodule - Comparison of Bayesian analysis and results of FDG-PET scan
Likelihood of malignancy in a solitary pulmonary nodule - Comparison of Bayesian analysis and results of FDG-PET scan
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DOI：
10.1378/chest.112.2.416
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发表时间：
1997-08-01
期刊：
影响因子：
9.6
通讯作者：
Ryschon, K
中科院分区：
文献类型：
--
作者：
Dewan, NA;Shehan, CJ;Ryschon, K
目的：比较标准标准与贝叶斯分析和2-[F-18]-2-脱氧-D-葡萄糖正电子发射断层扫描(FDG-PET)结果在孤立性肺结节中发生癌的概率。地点：一所大学医院和一个教学退伍军人事务医学中心。方法：回顾分析52例孤立性肺结节的CT和FDG-PET扫描结果。FDG-PET扫描分为异常和正常两类。利用贝叶斯分析，根据患者的年龄、既往恶性肿瘤病史、吸烟史、结节的大小和边缘、钙化的存在或不存在计算出使用文献中可用的‘标准标准’的癌症概率，并与基于异常或正常FDG-PET扫描的癌症概率进行比较。结果：在FDG-PET扫描异常的孤立性肺结节中，恶性的可能性比为7.11(95%可信区间6.36~7.96)，提示恶性的可能性很高；当PET扫描正常时，恶性的可能性比为0.06(95%CI，0.05~0.07)，提示良性结节的可能性很高。结论：FDG-PET单项检查对孤立性肺结节恶性程度的预测优于贝叶斯分析的标准标准。FDG-PET扫描是评价孤立性肺结节的一种有用的辅助检查。
Objective: To compare the probability of cancer in a solitary pulmonary nodule using standard criteria with Bayesian analysis and result of 2-[F-18] fluoro-2-deoxy-D-glucose-positron emission tomographic (FDG-PET) scan.Setting: A university hospital and a teaching Veteran Affairs Medical Center.Methods: Retrospective analysis of 52 patients who had under gone both CT scan of the chest and a FDG-PET scan for evaluation of a solitary pulmonary nodule. FDG-PET scan was classified as abnormal or normal. Utilizing Bayesian analysis, the probability of cancer using ''standard criteria'' available in the literature, based on patient's age, history of previous malignancy, smoking history, size and edge of nodule, and presence or absence of calcification were calculated and compared to the probability of cancer based on an abnormal or normal FDG-PET scan. Histologic study of the nodules was the gold standard.Results: The likelihood ratios for malignancy in a solitary pulmonary nodule with an abnormal FDG-PET scan was 7.11 (95% confidence interval [Cl], 6.36 to 7.96), suggesting a high probability for malignancy, and 0.06 (95% CI, 0.05 to 0.07) when the PET scan was normal, suggesting a high probability for benign nodule. FDG-PET scan as a single test alone was more accurate than the standard criteria and standard criteria plus PET scan in correctly classifying nodules as malignant or benign.Conclusion: FDG-PET scan as a single test was a better predictor of malignancy in solitary pulmonary nodules than the standard criteria using Bayesian analysis. FDG-PET scan can be a useful adjunct test in the evaluation of solitary pulmonary nodules.