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. 1996 Dec;21(12):941-9.
doi: 10.1097/00003072-199612000-00005.

Differentiating benign from malignant lung lesions using "quantitative" parameters of FDG PET images

K F Hübner  1 , E Buonocore, H R Gould, J Thie, G T Smith, S Stephens, J Dickey
Affiliations

Differentiating benign from malignant lung lesions using "quantitative" parameters of FDG PET images

K F Hübner et al. Clin Nucl Med. 1996 Dec.

Abstract

Fluorine-18 labeled deoxyglucose positron-emission tomography (FDG-PET) applications in oncology include the differential diagnosis of chest masses and single pulmonary nodules. However, FDG is not tumor-specific; rather, it also accumulates in inflammatory processes. This study was performed to identify image parameters that would improve the specificity of PET.

Methods: Twenty-six patients who had benign and malignant lung lesions were examined retrospectively. Positron-emission tomography data were acquired in dynamic scanning mode after intravenous bolus of 250-402 MBq of FDG. Standardized uptake values (SUVs) were calculated and Patlak analyses were performed in selected regions of interest in the PET images. Positron-emission tomography results were related to histological diagnosis (N = 49) or clinical follow-up (N = 3).

Results: The specificity and sensitivity of the original PET scan reports, which was based on visual image interpretation and loosely applied SUVs, was 100% and 73%, respectively. Using the SUVs with a cut-off value of 3.8 and Kpat value with a cut-off at 0.025 min-1 improved the specificity to 81% and 85%.

Conclusion: FDG-PET image interpretation can be facilitated by using SUV information or the accumulation rate of the radiotracer (Patlak). With additional validation, this method could have a significant cost-effective impact on the medical/surgical management of chest masses.

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