Impact of dual-time-point (18)F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules.
OBJECTIVE
Our aim was to assess the diagnostic potential of (18)F-FDG PET using partial volume correction and dual-time-point imaging in the assessment of solitary pulmonary nodules.


METHODS
We included 265 patients in this retrospective study (171 men; 94 women; age range, 41-92 years). All had pulmonary nodules on CT, and diagnosis was confirmed by biopsy or follow-up CT. All underwent whole body FDG PET, 60 min after FDG injection. Of the 265 patients, 255 underwent second FDG PET for chest 100 min after injection. Maximum SUVs for nodules were calculated from both scans. Partial volume correction for first time SUVs was applied, using coefficient factor. Malignancy was defined using the following criteria: (1) Visual assessment; (2) First time SUV > or = 2.5; (3) Partial volume corrected first time SUV > or = 2.5; (4) second time SUV > or = 2.5; (5) Increase in SUV over time; (6) Increase or no change in SUV; (7) First time SUV > or = 2.5 and/or increase or no change in SUV.


RESULTS
Biopsy and follow-up revealed 72 malignant lung nodules and 193 benign nodules. Sensitivity, specificity and accuracy for the five criteria were as follows: (1) 97, 58 and 68%; (2) 65, 92 and 85%; (3) 84, 91 and 89%; (4) 90, 80 and 83%; (5) 84, 95 and 92%; (6) 92, 92, and 92%; (7) 95, 90 and 91%, respectively.


CONCLUSIONS
Dual-time-point (18)F-FDG PET has potential impact on improving the diagnostic accuracy for malignant lung nodules. Dual-time-point (18)F-FDG PET imaging should be included in the clinical work-up of patients with pulmonary nodule.
Alkhawaldeh
Khaled
K
Department of Radiology, Nuclear Medicine Division, King Hussein Hospital, Amman, Jordan. khaledk73@gmail.com
Bural
Gonca
G
Kumar
Rakesh
R
Alavi
Abass
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18