title: Pulmonary nodules: differential diagnosis using 18F-fluorodeoxyglucose single-photon emission computed tomography.
abstract: OBJECTIVE
  The objective of this study was to prospectively evaluate the feasibility and efficacy of single-photon emission computed tomography (SPECT) with 18F-fluorodeoxyglucose (FDG) for differentiating malignant from benign pulmonary nodules.
  
  
  METHODS
  Twenty-six patients with 28 radiologically indeterminate focal pulmonary lesions were examined. Fasting patients were injected with 5 MBq/kg of FDG (maximum dose, 370 MBq). Imaging was performed with dual-head SPECT cameras equipped with 511-keV collimators.
  
  
  RESULTS
  Seventeen of 21 pathologically malignant nodules showed FDG uptake on SPECT imaging (sensitivity, 81%). None of the seven benign modules showed uptake (specificity, 100%). SPECT imaging with FDG was positive in all 16 malignant nodules that were larger than or equal to 2 cm in diameter. However, only one (20%) of five nodules smaller than 2 cm in diameter showed positive on SPECT imaging.
  
  
  CONCLUSIONS
  Using current technology, we found FDG SPECT imaging useful for distinguishing benign from malignant pulmonary nodules that were larger than or equal to 2 cm in diameter. However, because of the relatively low sensitivity of SPECT, smaller malignant nodules were not adequately revealed.
authors.affiliation: Division of Nuclear Medicine, Vancouver Hospital and Health Sciences Centre, B.C., Canada.
authors.forename: D F
authors.initials: DF
authors.lastname: Worsley
authors.forename: A
authors.initials: A
authors.lastname: Celler
authors.forename: M J
authors.initials: MJ
authors.lastname: Adam
authors.forename: J S
authors.initials: JS
authors.lastname: Kwong
authors.forename: N L
authors.initials: NL
authors.lastname: Müller
authors.forename: D B
authors.initials: DB
authors.lastname: Coupland
authors.forename: P
authors.initials: P
authors.lastname: Champion
authors.forename: R J
authors.initials: RJ
authors.lastname: Finley
authors.forename: K G
authors.initials: KG
authors.lastname: Evans
authors.forename: D M
authors.initials: DM
authors.lastname: Lyster
mesh_terms: D003847:Deoxyglucose / Q000031:analogs & derivatives*; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose