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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-07-2019 | Computed Tomography | Original Article

Development and validation of the PET-CT score for diagnosis of malignant pleural effusion

Authors: Min-Fu Yang, Zhao-Hui Tong, Zhen Wang, Ying-Yi Zhang, Li-Li Xu, Xiao-Juan Wang, Wan Li, Xiu-Zhi Wu, Wen Wang, Yu-Hui Zhang, Tao Jiang, Huan-Zhong Shi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2019

Abstract

Purpose

Although some parameters of positron emission tomography with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) and computed tomography (PET-CT) are somehow helpful in differentiating malignant pleural effusion (MPE) from benign effusions, no individual parameter offers sufficient evidence for its implementation in the clinical practice. The aim of this study was to establish the diagnostic accuracy of a scoring system based on PET-CT (the PET-CT score) in diagnosing MPE.

Methods

One prospective derivation cohort of patients with pleural effusions (84 malignant and 115 benign) was used to develop the PET-CT score for the differential diagnosis of malignant pleural effusion. The PET-CT score was then validated in another independent prospective cohort (n = 74).

Results

The PET-CT parameters developed for discriminating MPE included unilateral lung nodules and/or masses with increased ¹⁸F-FDG uptake (3 points); extrapulmonary malignancies (3 points); pleural thickening with increased ¹⁸F-FDG uptake (2 points); multiple nodules or masses (uni- or bilateral lungs) with increased ¹⁸F-FDG uptake (1 point); and increased pleural effusion ¹⁸F-FDG uptake (1 point). With a cut-off value of 4 points in the derivation cohort, the area under the curve, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the PET-CT score to diagnose MPE were 0.949 (95% CI: 0.908–0.975), 83.3% (73.6%–90.6%), 92.2% (85.7%–96.4%), 10.7 (5.6–20.1), and 0.2 (0.1–0.3), respectively.

Conclusions

A simple-to-use PET-CT score that uses PET-CT parameters was developed and validated. The PET-CT score can help physicians to differentiate MPE from benign pleural effusions.

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Title: Development and validation of the PET-CT score for diagnosis of malignant pleural effusion
Authors: Min-Fu Yang
Zhao-Hui Tong
Zhen Wang
Ying-Yi Zhang
Li-Li Xu
Xiao-Juan Wang
Wan Li
Xiu-Zhi Wu
Wen Wang
Yu-Hui Zhang
Tao Jiang
Huan-Zhong Shi
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Pleural Effusion
Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04287-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Development and validation of the PET-CT score for diagnosis of malignant pleural effusion

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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