Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule.

Cheon, Eun Mee; Kim, Byung Tae; Kwon, O. Jung; Kim, Hojoong; Chung, Man Pyo; Rhee, Chong H.; Han, Yong Chol; Lee, Kyung Soo; Shim, Young Mog; Kim, Jhingook; Han, Jungho

doi:1996.43.6.882

Tuberc Respir Dis > Volume 43(6); 1996 > Article

Original Article

Tuberculosis and Respiratory Diseases 1996;43(6):882-893.
DOI: https://doi.org/10.4046/trd.1996.43.6.882 Published online December 1, 1996.

Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule.

Eun Mee Cheon, Byung Tae Kim, O. Jung Kwon, Hojoong Kim, Man Pyo Chung, Chong H. Rhee, Yong Chol Han, Kyung Soo Lee, Young Mog Shim, Jhingook Kim, Jungho Han

¹Division of Pulmonology, Department of Internal Medicine, Samsung Medical Center, Korea.
²Department of Nuclear Medicine, Samsung Medical Center, Korea.
³Department of Radiology, Samsung Medical Center, Korea.
⁴Department of Thoracic Surgery, Samsung Medical Center, Korea.
⁵Department of Pathology, Samsung Medical Center, Korea.

Abstract

METHOD: 34 patients with a solitary pulmonary nodule less than 6 cm of its diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FDG-PET scan were performed for all patients. The results of FDG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results: (1) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(P>0.05). (2) Peak SUV (standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 cm diameter. (4) FDG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FDG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule that has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

Key Words: solitary pulmonary nodule, FDG-PET

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