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Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2008

01-02-2008 | Original article

Impact of dual-time-point 18F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules

Authors: Khaled Alkhawaldeh, Gonca Bural, Rakesh Kumar, Abass Alavi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2008

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Abstract

Purpose

Our aim was to assess the diagnostic potential of 18F-FDG PET using partial volume correction and dual-time-point imaging in the assessment of solitary pulmonary nodules.

Methods

We included 265 patients in this retrospective study (171 men; 94 women; age range, 41–92 years). All had pulmonary nodules on CT, and diagnosis was confirmed by biopsy or follow-up CT. All underwent whole body FDG PET, 60 min after FDG injection. Of the 265 patients, 255 underwent second FDG PET for chest 100 min after injection. Maximum SUVs for nodules were calculated from both scans. Partial volume correction for first time SUVs was applied, using coefficient factor. Malignancy was defined using the following criteria: (1) Visual assessment; (2) First time SUV ≥ 2.5; (3) Partial volume corrected first time SUV ≥ 2.5; (4) second time SUV ≥ 2.5; (5) Increase in SUV over time; (6) Increase or no change in SUV; (7) First time SUV ≥ 2.5 and/or increase or no change in SUV.

Results

Biopsy and follow-up revealed 72 malignant lung nodules and 193 benign nodules. Sensitivity, specificity and accuracy for the five criteria were as follows: (1) 97, 58 and 68%; (2) 65, 92 and 85%; (3) 84, 91 and 89%; (4) 90, 80 and 83%; (5) 84, 95 and 92%; (6) 92, 92, and 92%; (7) 95, 90 and 91%, respectively.

Conclusion

Dual-time-point 18F-FDG PET has potential impact on improving the diagnostic accuracy for malignant lung nodules. Dual-time-point 18F-FDG PET imaging should be included in the clinical work-up of patients with pulmonary nodule.
Literature
1.
go back to reference Houri NF, Meziane MA, Zerhouni EA, Fishman EK, Siegelman SS. The solitary pulmonary nodule. Chest 1987;91:128–33.CrossRef Houri NF, Meziane MA, Zerhouni EA, Fishman EK, Siegelman SS. The solitary pulmonary nodule. Chest 1987;91:128–33.CrossRef
2.
go back to reference Viggiano RW, Swensen SJ, Rosenow EC III. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1992;13:83–95.PubMed Viggiano RW, Swensen SJ, Rosenow EC III. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1992;13:83–95.PubMed
3.
go back to reference Lillington GA. Disease-a-Month 37th ed. St Louis, MO: Mosby-Year Book, 1991. p. 271–318. Lillington GA. Disease-a-Month 37th ed. St Louis, MO: Mosby-Year Book, 1991. p. 271–318.
4.
go back to reference Gomstock GW, Vaughan RH, Montgomery G. Outcome of solitary pulmonary nodules discovered in an x-ray screening program. N Engl J Med 1956;254:1018–22.CrossRef Gomstock GW, Vaughan RH, Montgomery G. Outcome of solitary pulmonary nodules discovered in an x-ray screening program. N Engl J Med 1956;254:1018–22.CrossRef
5.
go back to reference Gurney JW. Determining the likelihood of malignancy in solitary pulmonary nodules with Baysian analysis. Part I. Theory. Radiology 1993;186:405–13.PubMed Gurney JW. Determining the likelihood of malignancy in solitary pulmonary nodules with Baysian analysis. Part I. Theory. Radiology 1993;186:405–13.PubMed
6.
go back to reference Higgins GA, Shields TW, Keehn RJ. The solitary pulmonary nodule. Arch Surg 1975;110:570–5.PubMed Higgins GA, Shields TW, Keehn RJ. The solitary pulmonary nodule. Arch Surg 1975;110:570–5.PubMed
7.
go back to reference Lillington GA, Caskey CI. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1993;14:111–9.PubMed Lillington GA, Caskey CI. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1993;14:111–9.PubMed
8.
go back to reference Midthun DE, Swensen SJ, Jett JR. Approach to the solitary pulmonary nodule. Mayo Clin Proc 1993;68:378–85.PubMed Midthun DE, Swensen SJ, Jett JR. Approach to the solitary pulmonary nodule. Mayo Clin Proc 1993;68:378–85.PubMed
9.
go back to reference Steele JD, Kleitsch WP, Dunn JEJ, Buell P. Survival in males with bronchogenic carcinomas resected as asymptomatic solitary pulmonary nodules. Ann Thorac Surg 1996;2:368–76.CrossRef Steele JD, Kleitsch WP, Dunn JEJ, Buell P. Survival in males with bronchogenic carcinomas resected as asymptomatic solitary pulmonary nodules. Ann Thorac Surg 1996;2:368–76.CrossRef
10.
go back to reference Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305–32.PubMedCrossRef Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305–32.PubMedCrossRef
11.
go back to reference Kumar R, Bhargava P, Bozkurt MF, Zhuang H, Potenta S, Alavi A. Positron emission tomography imaging in evaluation of cancer patients. Indian J Cancer 2003;40:87–100.PubMed Kumar R, Bhargava P, Bozkurt MF, Zhuang H, Potenta S, Alavi A. Positron emission tomography imaging in evaluation of cancer patients. Indian J Cancer 2003;40:87–100.PubMed
12.
go back to reference Hustinx R, Smith RJ, Benard F, et al. Dual time point fluorine-18 fluorodeoxyglucose positron emission tomography: a potential method to differentiate malignancy from inflammation and normal tissue in the head and neck. Eur J Nucl Med 1999;26:1345–8.PubMedCrossRef Hustinx R, Smith RJ, Benard F, et al. Dual time point fluorine-18 fluorodeoxyglucose positron emission tomography: a potential method to differentiate malignancy from inflammation and normal tissue in the head and neck. Eur J Nucl Med 1999;26:1345–8.PubMedCrossRef
13.
go back to reference Zhuang H, Pourdehnad M, Lambright ES, et al. Dual time point 18F-FDG PET imaging for differentiating malignant from inflammatory processes. J Nucl Med 2001;42:1412–7.PubMed Zhuang H, Pourdehnad M, Lambright ES, et al. Dual time point 18F-FDG PET imaging for differentiating malignant from inflammatory processes. J Nucl Med 2001;42:1412–7.PubMed
14.
go back to reference Buck A, Schirrmeister H, Kuhn T, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging 2002;29:1317–23.PubMedCrossRef Buck A, Schirrmeister H, Kuhn T, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging 2002;29:1317–23.PubMedCrossRef
15.
go back to reference Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual-time-point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med 2002;43:871–5.PubMed Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual-time-point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med 2002;43:871–5.PubMed
16.
17.
go back to reference Kubota K, Matsuzawa T, Fujiwara T, et al. Differential diagnosis of lung tumor with positron emission tomography: a prospective study. J Nucl Med 1990;31:1927–32.PubMed Kubota K, Matsuzawa T, Fujiwara T, et al. Differential diagnosis of lung tumor with positron emission tomography: a prospective study. J Nucl Med 1990;31:1927–32.PubMed
18.
go back to reference Gupta NC, Frank AR, Dewan NA, et al. Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro-2-deoxy-d-glucose. Radiology 1992;184:441–4.PubMed Gupta NC, Frank AR, Dewan NA, et al. Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro-2-deoxy-d-glucose. Radiology 1992;184:441–4.PubMed
19.
go back to reference Patz EF, Lowe VJ, Hoffman JM, et al. Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning. Radiology 1993;188:487–90.PubMed Patz EF, Lowe VJ, Hoffman JM, et al. Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning. Radiology 1993;188:487–90.PubMed
20.
go back to reference Dewan NA, Gupta NC, Redepenning LS, Phalen JJ, Frick MP. Diagnostic efficacy of FDG-PET imaging in solitary pulmonary nodules: potential role in evaluation and management. Chest 1993;104:997–1002.PubMedCrossRef Dewan NA, Gupta NC, Redepenning LS, Phalen JJ, Frick MP. Diagnostic efficacy of FDG-PET imaging in solitary pulmonary nodules: potential role in evaluation and management. Chest 1993;104:997–1002.PubMedCrossRef
21.
go back to reference Lowe VJ, Fletcher JW, Gobar L, et al. Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol 1998;16;1075–84.PubMed Lowe VJ, Fletcher JW, Gobar L, et al. Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol 1998;16;1075–84.PubMed
22.
go back to reference Präuer HW, Weber WA, Römer W, Treumann T, Ziegler SI, Schwaiger M. Controlled prospective study of positron emission tomography using the glucose analogue [18F]fluorodeoxyglucose in the evaluation of pulmonary nodules. Br J Surg 1998;85:1506–11.PubMedCrossRef Präuer HW, Weber WA, Römer W, Treumann T, Ziegler SI, Schwaiger M. Controlled prospective study of positron emission tomography using the glucose analogue [18F]fluorodeoxyglucose in the evaluation of pulmonary nodules. Br J Surg 1998;85:1506–11.PubMedCrossRef
23.
go back to reference Kotaro H, Yoshimichi U, Hiroyasu S, et al. Fluorine-18-FDG PET imaging is negative in bronchioalveolar carcinoma. J Nucl Med 1998;39:1016–20. Kotaro H, Yoshimichi U, Hiroyasu S, et al. Fluorine-18-FDG PET imaging is negative in bronchioalveolar carcinoma. J Nucl Med 1998;39:1016–20.
24.
go back to reference Nomori H, Watanabe K, Ohtsuka T, Naruke T, Suemasu K, Uno K. Visual and semiquantitative analyses for F-18 fluorodeoxyglucose PET scanning in pulmonary nodules 1 cm to 3 cm in size. Ann Thorac Surg 2005;79:984–8.PubMedCrossRef Nomori H, Watanabe K, Ohtsuka T, Naruke T, Suemasu K, Uno K. Visual and semiquantitative analyses for F-18 fluorodeoxyglucose PET scanning in pulmonary nodules 1 cm to 3 cm in size. Ann Thorac Surg 2005;79:984–8.PubMedCrossRef
25.
go back to reference Hickeson M, Yun M, Matthies A, et al. Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET. Eur J Nucl Med Mol Imaging 2002;29:1639–47.PubMedCrossRef Hickeson M, Yun M, Matthies A, et al. Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET. Eur J Nucl Med Mol Imaging 2002;29:1639–47.PubMedCrossRef
26.
go back to reference Weber W, Young C, Abdel-Dayem HM, et al. Assessment of pulmonary lesions with 18F-fluorodeoxyglucose positron imaging using coincidence mode gamma cameras. J Nucl Med 1999;40:574–8.PubMed Weber W, Young C, Abdel-Dayem HM, et al. Assessment of pulmonary lesions with 18F-fluorodeoxyglucose positron imaging using coincidence mode gamma cameras. J Nucl Med 1999;40:574–8.PubMed
27.
28.
go back to reference Dewan NA, Shehan CJ, Reeb SD, Gobar LS, Scott WJ, Ryschon K. Likelihood of malignancy in a solitary pulmonary nodule: comparison of Bayesian analysis and results of FDG-PET scan. Chest 1997;112:416–22.PubMed Dewan NA, Shehan CJ, Reeb SD, Gobar LS, Scott WJ, Ryschon K. Likelihood of malignancy in a solitary pulmonary nodule: comparison of Bayesian analysis and results of FDG-PET scan. Chest 1997;112:416–22.PubMed
29.
go back to reference Herder GJ, Golding RP, Hoekstra OS, et al. The performance of 18F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules. Eur J Nucl Med Mol Imaging 2004;31:1231–6.PubMedCrossRef Herder GJ, Golding RP, Hoekstra OS, et al. The performance of 18F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules. Eur J Nucl Med Mol Imaging 2004;31:1231–6.PubMedCrossRef
30.
go back to reference 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(3):426–31.PubMed 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(3):426–31.PubMed
31.
go back to reference Demura Y, Tsuchida T, Ishizaki T, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med 2003;44:540–8.PubMed Demura Y, Tsuchida T, Ishizaki T, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med 2003;44:540–8.PubMed
32.
go back to reference Kumar R, Loving VA, Chauhan A, Zhuang H, Mitchell S, Alavi A. Potential of dual-time-point imaging to improve breast cancer diagnosis with 18F-FDG PET. J Nucl Med 46(11):1819–24. Kumar R, Loving VA, Chauhan A, Zhuang H, Mitchell S, Alavi A. Potential of dual-time-point imaging to improve breast cancer diagnosis with 18F-FDG PET. J Nucl Med 46(11):1819–24.
33.
go back to reference Lubberink M, Tolmachev V, Widström C, Bruskin A, Lundqvist H, Westlin JE. 110mIn-DTPA-D-Phe1-Octreotide for Imaging of Neuroendocrine tumours with PET.J Nucl Med 2002;43:1391–7.PubMed Lubberink M, Tolmachev V, Widström C, Bruskin A, Lundqvist H, Westlin JE. 110mIn-DTPA-D-Phe1-Octreotide for Imaging of Neuroendocrine tumours with PET.J Nucl Med 2002;43:1391–7.PubMed
34.
go back to reference Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med 1994;35:1308–12.PubMed Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med 1994;35:1308–12.PubMed
35.
go back to reference Nakamoto Y, Higashi T, Sakahara H, et al. Delayed 18F-FDG PET scan for the differentiation between malignant and benign lesions [abstract]. J Nucl Med 1999;40(suppl):247P. Nakamoto Y, Higashi T, Sakahara H, et al. Delayed 18F-FDG PET scan for the differentiation between malignant and benign lesions [abstract]. J Nucl Med 1999;40(suppl):247P.
36.
go back to reference Lodge MA, Lucas JD, Marsden PK, Cronin BF, O’Doherty MJ, Smith MA. A PET study of 18FDG uptake in soft tissue masses. Eur J Nucl Med 1999;26:22–30.PubMedCrossRef Lodge MA, Lucas JD, Marsden PK, Cronin BF, O’Doherty MJ, Smith MA. A PET study of 18FDG uptake in soft tissue masses. Eur J Nucl Med 1999;26:22–30.PubMedCrossRef
37.
go back to reference Ponzo F, Zhuang HM, Liu FM, et al. Can the difference of the levels of glucose-6-phosphatase explain the mechanism of FDG-PET dual time point imaging? Eur J Nucl Med 2001;28:OS399. Ponzo F, Zhuang HM, Liu FM, et al. Can the difference of the levels of glucose-6-phosphatase explain the mechanism of FDG-PET dual time point imaging? Eur J Nucl Med 2001;28:OS399.
38.
go back to reference Knight SB, Delbeke D, Stewart JR, Sandler MP. Evaluation of pulmonary lesions with FDG-PET. Chest 1996;109:982–8.PubMed Knight SB, Delbeke D, Stewart JR, Sandler MP. Evaluation of pulmonary lesions with FDG-PET. Chest 1996;109:982–8.PubMed
39.
go back to reference Kapucu LO, Meltzer CC, Townsend DW, Keenan RJ, Luketich JD. Fluorine-18-fluoro-deoxyglucose uptake in pneumonia. J Nucl Med 1998;39:1267–9.PubMed Kapucu LO, Meltzer CC, Townsend DW, Keenan RJ, Luketich JD. Fluorine-18-fluoro-deoxyglucose uptake in pneumonia. J Nucl Med 1998;39:1267–9.PubMed
Metadata
Title
Impact of dual-time-point 18F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules
Authors
Khaled Alkhawaldeh
Gonca Bural
Rakesh Kumar
Abass Alavi
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0584-1

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