title: Detection and staging of preinvasive lesions and occult lung cancer in the central airways with 18F-fluorodeoxyglucose positron emission tomography: a pilot study.
abstract: OBJECTIVE
  To evaluate the role of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in radiologically occult preinvasive lesions and lung cancer in the central airways.
  
  
  METHODS
  Twenty-two patients with 24 preinvasive lesions and early squamous cell cancer (SCC) being occult on high-resolution computed tomography were studied. All lesions were diagnosed based on histology sampled using autofluorescence bronchoscopy. FDG-PET findings were correlated with WHO histologic classification. FDG-PET was considered true-positive when the final diagnosis was SCC and true-negative when the lesions were classified as severe dysplasia or less.
  
  
  RESULTS
  FDG-PET was true-positive in 8 of 11 and true-negative in 11 of 13 cases corresponding with a sensitivity of 73% [95% confidence interval (CI), 0.43-0.91] and specificity of 85% (95% CI, 0.57-0.97). Positive and negative predictive values were 80% (95% CI, 0.48-0.96) and 79% (95% CI, 0.52-0.93), respectively.
  
  
  CONCLUSIONS
  Our very preliminary data suggest that FDG-PET might be useful for the evaluation of early central airway lesions, being positive in most SCC and negative in cases of severe dysplasia. Validation in a larger multicenter study is needed.
authors.affiliation: Department of Pulmonology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
authors.forename: Arifa
authors.initials: A
authors.lastname: Pasic
authors.forename: Hes A
authors.initials: HA
authors.lastname: Brokx
authors.forename: Emile F
authors.initials: EF
authors.lastname: Comans
authors.forename: Gerarda J
authors.initials: GJ
authors.lastname: Herder
authors.forename: Elle K
authors.initials: EK
authors.lastname: Risse
authors.forename: Otto S
authors.initials: OS
authors.lastname: Hoekstra
authors.forename: Pieter E
authors.initials: PE
authors.lastname: Postmus
authors.forename: Tom G
authors.initials: TG
authors.lastname: Sutedja
mesh_terms: D000368:Aged; D001999:Bronchoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18