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Review
. 2016 Mar-Apr;49(2):104-11.
doi: 10.1590/0100-3984.2014.0087.

Solitary pulmonary nodule and (18)F-FDG PET/CT. Part 2: accuracy, cost-effectiveness, and current recommendations

Marcos Pretto Mosmann  1 , Marcelle Alves Borba  2 , Francisco Pires Negromonte de Macedo  2 , Adriano de Araujo Lima Liguori  2 , Arthur Villarim Neto  3 , Kenio Costa de Lima  4
Affiliations
Review

Solitary pulmonary nodule and (18)F-FDG PET/CT. Part 2: accuracy, cost-effectiveness, and current recommendations

Marcos Pretto Mosmann et al. Radiol Bras. 2016 Mar-Apr.

Abstract
in English, Portuguese

A solitary pulmonary nodule is a common, often incidental, radiographic finding. The investigation and differential diagnosis of solitary pulmonary nodules remain complex, because there are overlaps between the characteristics of benign and malignant processes. There are currently many strategies for evaluating solitary pulmonary nodules. The main objective is to identify benign lesions, in order to avoid exposing patients to the risks of invasive methods, and to detect cases of lung cancer accurately, in order to avoid delaying potentially curative treatment. The focus of this study was to review the evaluation of solitary pulmonary nodules, to discuss the current role of (18)F-fluorodeoxyglucose positron-emission tomography, addressing its accuracy and cost-effectiveness, and to detail the current recommendations for the examination in this scenario.

O nódulo pulmonar solitário corresponde a um achado radiológico comum, cuja detecção ocorre frequentemente de forma incidental. A investigação desta entidade permanece complexa, uma vez que existem sobreposições entre as características dos processos benignos e malignos no seu diagnóstico diferencial. Atualmente, muitas estratégias estão disponíveis para a avaliação do nódulo pulmonar solitário, e o objetivo principal consiste em caracterizar da melhor forma possível as alterações benignas, não expondo os pacientes aos riscos de métodos invasivos, e detectar corretamente os casos de câncer de pulmão, não retardando potencial tratamento curativo. O foco deste estudo é revisar a avaliação do nódulo pulmonar solitário, discutindo o papel atual da tomografia por emissão de pósitrons com 18-fluordesoxiglicose, apresentar sua acurácia e custo-efetividade, bem como salientar as recomendações atuais do exame neste cenário.

Keywords: Positron-emission tomography; Solitary pulmonary nodule.

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Figures

Figure 1
Figure 1
A: Axial fused 18F-FDG PET/CT image. B: Axial PET image. Patient with history of epidermoid cervical carcinoma, referred for indeterminate pulmonary nodule research. Upon 18F-FDG PET/CT examination, the nodule displayed increased glycolytic metabolism (SUVmax = 5.6). She was submitted to surgery, which confirmed the hypothesis of involvement of the underlying disease.
Figure 2
Figure 2
A: Axial fused 18F-FDG PET/CT image. B: Axial PET image. Patient with no history of cancer referred for investigation of an indeterminate pulmonary nodule. Upon 18F-FDG PET/CT examination, the pulmonary nodule showed no anomalous accumulation of the tracer.
Figure 3
Figure 3
A: Axial fused 18F-FDG PET/CT image. B: Axial chest CT image. C: Axial fused 18F-FDG PET/CT image. D: PET axial image. Patient with a history of gastrointestinal stromal tumor presenting with indeterminate pulmonary nodule in the right lower lobe in a previous CT scan. Upon 18F-FDG PET/CT examination, the nodule displayed slightly increased glycolytic metabolism when compared with normal lung parenchyma (arrows in A and B), together with hypermetabolic ipsilateral hilar lymph nodes (C and D). The patient underwent surgery, which further confirmed the diagnosis of tuberculosis.
See this image and copyright information in PMC

References

    1. Gould MK, Maclean CC, Kuschner WG, et al. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA. 2001;285:914–924. - PubMed
    1. Fletcher JW, Kymes SM, Gould MK, et al. A comparison of the diagnostic accuracy of 18F-FDG PET and CT in the characterization of solitary pulmonary nodules. J Nucl Med. 2008;49:179–185. - PubMed
    1. Grgic A, Yüksel Y, Gröschel A, et al. Risk stratification of solitary pulmonary nodules by means of PET using (18)F-fluorodeoxyglucose and SUV quantification. Eur J Nucl Med Mol Imaging. 2010;37:1087–1094. - PubMed
    1. Hashimoto Y, Tsujikawa T, Kondo C, et al. Accuracy of PET for diagnosis of solid pulmonary lesions with 18F-FDG uptake below the standardized uptake value of 2.5. J Nucl Med. 2006;47:426–431. - PubMed
    1. Herder GJ, Golding RP, Hoekstra OS, et al. The performance of (18)F-fluorodeoxiglucose positron emission tomography in small solitary pulmonary nodules. Eur J Nucl Med Mol Imaging. 2004;31:1231–1236. - PubMed

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