title: The solitary pulmonary nodule--is it malignant or benign? Diagnostic performance of Tc-depreotide SPECT.
abstract: BACKGROUND
  The diagnosis of malignancy may be difficult to establish in solitary pulmonary nodules (SPNs).
  
  
  OBJECTIVE
  It was the aim of this study to assess diagnostic performances of technetium-99m ((99m)Tc)-depreotide in differentiating benign from malignant SPNs and compare its diagnostic accuracy with fluor-18-fluoro-deoxyglucose positron emission tomography (FDG-PET) in a subgroup of patients.
  
  
  METHODS
  One hundred and eighteen patients presenting with an SPN < or =3 cm suspected of malignancy on CT were included in a prospective, open-label, European multicentre trial. Single photon emission computed tomography (SPECT) images were acquired 1.1-4.5 h after injection of 459-770 MBq of (99m)Tc-depreotide. A subset of 29 patients also underwent FDG-PET imaging. Images were interpreted blindly and correlated with histopathology.
  
  
  RESULTS
  (99m)Tc-depreotide was positive in 65 of 73 patients with a malignant lesion and negative in 30 of 45 patients with a benign lesion, resulting in a sensitivity, specificity and diagnostic accuracy of 89, 67 and 81%, respectively. In 40 patients with SPN < or =1.5 cm, diagnostic accuracy was 88, sensitivity 75 and specificity 96%. In the subset of 29 patients who underwent both (99m)Tc-depreotide SPECT and FDG-PET imaging, sensitivity, specificity and diagnostic accuracy were identical for both modalities, i.e. 90, 67 and 83%, respectively.
  
  
  CONCLUSIONS
  The diagnostic accuracy of (99m)Tc-depreotide SPECT is good and comparable with FDG-PET imaging in SPN of indeterminate origin.
authors: Department of Respiratory Medicine, Rikshospitalet, Oslo, Norway. anne.naalsund@rikshospitalet.no
authors: Anne
authors: A
authors: Naalsund
authors: Jean
authors: J
authors: Maublant