Abstract
Background
We explored the role of dual time point fluorodeoxyglucose positron emission tomography/computed
tomography (DTP PET/CT) scan in the differentiation of benign and malignant lung and
mediastinal lesions.
Methods
We studied a sample of 72 consecutive patients who underwent DTP PET/CT scan for intrathoracic
lesions. Information on demographics, initial and delayed maximum standardized uptake
values (SUVmax) of lesions and final diagnosis were collected. Clinical criteria to
diagnose benign lesions were defined as stability or regression of the lesion on follow-up
after 2 years of initial detection. Sensitivity, specificity, predictive values and
likelihood ratio and retention index were calculated using standard methods.
Results
Sixty-three (87%) patients had increased SUVmax in delayed scan (1 hour after initial
scan). Among the patients with increased delayed uptake, 51 (80%) had malignant lesion
and 12 (20%) had nonmalignant lesions. All 9 patients whose SUVmax decreased on delayed
scan had nonmalignant lesions. The increased SUV on delayed scan was 100% sensitive
in diagnosis of cancer but was only 42% specific. The positive predictive value was
80%, whereas the negative predictive value was 100%. Likelihood ratio for positive
test was 1.75.
Conclusions
All the lesions with decreased SUVmax in delayed PET scan were nonmalignant. This
was true for both lung and mediastinal lesions. This could be a very helpful diagnostic
finding in areas with high prevalence of benign conditions such as histoplasmosis
and sarcoidosis. Multiple invasive diagnostic modalities could be prevented in a significant
percentage of patients, with attendant decrease in morbidity and health care costs.
Key Indexing Terms
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Article info
Publication history
Accepted:
October 16,
2012
Received:
May 7,
2012
Footnotes
Disclosure: The authors have no funding or conflicts of interest to disclose.
Part of this study has been submitted in abstract form to American College of Chest Physicians (ACCP) annual meeting October 2012.
Identification
Copyright
© 2012 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
