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. 2012 Feb;45(1):35-9.
doi: 10.5090/kjtcs.2012.45.1.35. Epub 2012 Feb 7.

Comparing 18F-Fluorodeoxyglucose Positron Emission Tomography and Video-assisted Thoracoscopic Surgery in the Evaluation of Small Pulmonary Nodules in Patients with a History of Malignancy

Hong Kyu Lee  1 , Sung Woo Cho, Hee Sung Lee, Kun Il Kim, Hyoung Soo Kim, Seong Joon Cho
Affiliations

Comparing 18F-Fluorodeoxyglucose Positron Emission Tomography and Video-assisted Thoracoscopic Surgery in the Evaluation of Small Pulmonary Nodules in Patients with a History of Malignancy

Hong Kyu Lee et al. Korean J Thorac Cardiovasc Surg. 2012 Feb.

Abstract

Background: The aims of the study were to determine the accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting pulmonary metastasis through video-assisted thoracoscopic surgery (VATS), a technique that allows the excisional biopsy of small pulmonary nodules in patients with known malignancies.

Materials and methods: Between October 2007 and April 2010, 28 patients with known malignancies and small pulmonary nodules underwent VATS excisional biopsies. All patients were in follow-up for a previously treated malignancy. The malignancies included the following: colorectum (9), breast (6), head and neck (5), stomach (3), lymph (1), ovary (1), uterus (1), bladder (1), and liver (1).

Results: There were 16 men and 12 women whose mean age was 56.7 years old (range, 38 to 77 years). The sizes of the mean nodules removed were 11.3 mm (range, 7 to 21 mm). Diagnoses included metastatic (11), bronchioloalveolar carcinoma (1), primary adenocarcinoma (1), pulmonary tuberculosis (6), fibrosis (5), organizing pneumonia (3), lymphoid hyperplasia (1). Among these lesions, 46.4% were malignant.

Conclusion: True positive FDG-PET was 39.2%. FDG-PET is not a sensitive test in the evaluation of patients with a history of an extrathoracic malignancy and newly diagnosed small pulmonary nodules. VATS excision allows the early diagnosis of small pulmonary nodules, with low morbidity, in patients with known malignancies.

Keywords: Biopsy; Positive emission tomography; Video-assisted thoracic surgery.

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Figures

Fig. 1
Fig. 1
Receiver operating characteristics (ROC) curve for maximal standard uptake value (95% confidence interval).
Fig. 2
Fig. 2
Receiver operating characteristics (ROC) curve for tumor size (95% confidence interval).
See this image and copyright information in PMC

References

    1. Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA. 2001;285:914–924. - PubMed
    1. Sortini A, Carcoforo P, Ascanelli S, Sortini D, Pozza E. Significance of a single pulmonary nodule in patients with previous history of malignancy. Eur J Cardiothorac Surg. 2001;20:1101–1105. - PubMed
    1. Bryant AS, Cerfolio RJ, Klemm KM, Ojha B. Maximum standard uptake value of mediastinal lymph nodes on integrated FDG-PET-CT predicts pathology in patients with non-small cell lung cancer. Ann Thorac Surg. 2006;82:417–422. - PubMed
    1. Halter G, Storck M, Guhlmann A, Frank J, Grosse S, Liewald F. FDG positron emission tomography in the diagnosis of peripheral pulmonary focal lesions. Thorac Cardiovasc Surg. 2000;48:97–101. - PubMed
    1. Erasmus JJ, McAdams HP, Connolly JE. Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule. Radiographics. 2000;20:59–66. - PubMed

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