Performance of integrated FDG-PET/CT for differentiating benign and malignant lung lesions--results from a large prospective clinical trial.

Autor: Sandra Pauls, Andreas Buck, Gisela Halter, Felix Mottaghy, Rainer Muche, Christina Bluemel, Susanne Gerstner, Stefan Krüger, Gerhard Glatting, Ludger Sunder-Plassmann, Peter Möller, Hans-Jürgen Brambs, Sven Reske, Pauls, Sandra, Buck, Andreas K, Halter, Gisela, Mottaghy, Felix M, Muche, Rainer, Bluemel, Christina, Gerstner, Susanne
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Zdroj: Molecular Imaging & Biology; Mar2008, Vol. 10 Issue 2, p121-128, 8p
Abstrakt: Abstract Purpose  The purpose of the study was to evaluate prospectively whether integrated 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) is more accurate for determination of malignancy in newly diagnosed pulmonary lesions compared to separate interpretation of CT and FDG-PET. Procedures  Two hundred and seventy-six patients with newly diagnosed lung lesions underwent FDG-PET/CT. Helical CT, FDG-PET, and FDG-PET/CT were interpreted separately to determine the performance of each imaging modality. Histopathology served as reference in all patients, and in further 60 patients, a benign lesion was verified at follow-up (mean follow-up of 1,040 days). Results  Histology revealed malignant lung tumors in 216 of 276 patients. With PET and PET/CT, a significantly lower number of lesions were classified as equivocal compared to CT alone (p p = 0.021), and for PET/CT 96, 87, and 94% (p = 0.010). Assuming that equivocal lesions are malignant, sensitivity, specificity, and accuracy for CT was 99, 37, and 86%, for PET 99, 77, and 94% (p p = 0.002). PET and PET/CT showed the highest concordance (K = 0.912; confidence interval 0.866–0.958). In lesions less than or equal to 3 cm, there was a significant difference in the performance of PET alone and multidetector row CT as well as PET/CT and multidetector row CT (p = 0.007), irrespective if equivocal findings were judged as malignant or benign. Conclusion  For differentiation of benign from malignant lung lesions, integrated FDG-PET/CT imaging was significantly more accurate than CT but not FDG-PET. The addition of metabolic imaging (FDG-PET) to morphological imaging (CT) leads to an increase in specificity and significantly reduced equivocal findings and is therefore recommended to further specify newly diagnosed lung lesions. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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