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01-07-2009 | Original Article

Dual-time point ¹⁸F-FDG PET/CT scan for differentiation between ¹⁸F-FDG-avid non-small cell lung cancer and benign lesions

Authors: Kazuyoshi Suga, Yasuhiko Kawakami, Atsuto Hiyama, Kazurou Sugi, Kazutomo Okabe, Tsuneo Matsumoto, Kazuhiro Ueda, Nobuyuki Tanaka, Naofumi Matsunaga

Published in: Annals of Nuclear Medicine | Issue 5/2009

Abstract

Objective

The aim of this study is to clarify the difference of F-18 FDG uptake kinetics between FDG-avid non-small-cell lung cancer (NSCLC) and benign lesions associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.

Materials and methods

The materials were 76 FDG-avid solitary NSCLC in 76 patients and 57 FDG-avid solitary benign lesions associated with various etiologies in 61 patients. FDG PET/CT scan was performed at 60 and 120 min after intravenous injection of 4.4 MBq/kg F-18 FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax) between the two time points were measured. The optimal differential parameter was determined by receiver-operating characteristic curve analysis and evaluation of diagnostic accuracy.

Results

The mean ± SD of early SUV max, delayed SUVmax and %ΔSUVmax were 8.3 ± 5.2, and 10.2 ± 6.5, and 21.9% ± 18.9 in FDG-avid NSCLC, and 3.8 ± 3.2, 4.0 ± 3.7, and 11.3% ± 26.0 in FDG-avid benign lesions, respectively. Delayed SUVmax in NSCLC was significantly higher than early SUVmax (P < 0.0001); while not different in benign lesions. Percent change of SUVmax in NSCLC was also significantly higher than that in benign lesions (P < 0.01). The optimal parameter for the differentiation was delayed SUVmax > 5.5 and yielded sensitivity of 77.6%, specificity of 80.7% and accuracy of 78.9%, which provided better differentiation than the use of %ΔSUVmax or the traditional parameter of early SUVmax > 2.5. However, 11 (19.2%) benign lesions were indistinguishable from NSCLC.

Conclusion

Although delayed PET/CT scan enhances the difference of FDG uptake between FDG-avid NSCLC and benign lesions, and the use of delayed SUVmax > 5.5 appears to improve the differentiation of these hypermetabolic lesions compared with an early scan, careful interpretation and management for correct differentiation are still required.

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Title: Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions
Authors: Kazuyoshi Suga
Yasuhiko Kawakami
Atsuto Hiyama
Kazurou Sugi
Kazutomo Okabe
Tsuneo Matsumoto
Kazuhiro Ueda
Nobuyuki Tanaka
Naofumi Matsunaga
Publication date: 01-07-2009
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 5/2009
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-009-0260-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Dual-time point ¹⁸F-FDG PET/CT scan for differentiation between ¹⁸F-FDG-avid non-small cell lung cancer and benign lesions

Abstract

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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