FDG-PET imaging and the diagnosis of non-small cell lung cancer in a region of high histoplasmosis prevalence.
OBJECTIVE
Determine the sensitivity and specificity of [F-18]-fluorine-2-deoxy-D-glucose positron emission tomography (FDG-PET) in differentiating non-small cell lung cancer (NSCLC) from benign solitary pulmonary nodules (SPNs) in a region with a high endemic rate of histoplamosis.


METHODS
Prospective, clinical study.


METHODS
University, tertiary referral hospital in the upper Mississippi River valley.


METHODS
Ninety patients with SPNs.


METHODS
Independent interpretation of FDG-PET imaging, computed tomography and pathologic evaluation of the SPNs.


RESULTS
To detect malignant SPNs, FDG-PET imaging had a sensitivity of 93%, a specificity of 40%, a positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 55%.


CONCLUSIONS
In a region with a high prevalence of pulmonary fungal infection, FDG-PET is sensitive but has a low specificity and NPV for identifying NSCLC. In our study cohort, FDG-PET does not appear to reduce the need for SPN biopsies.
Croft
Donita R
DR
The University of Iowa, Iowa City, IA, USA. donitacroft@yahoo.com
Trapp
John
J
Kernstine
Kemp
K
Kirchner
Peter
P
Mullan
Brian
B
Galvin
Jeffery
J
Peterson
Michael W
MW
Gross
Thomas
T
McLennan
Geoffrey
G
Kern
Jeffrey A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006660:Histoplasmosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18