Evaluation of lung lesions using FDG gamma-camera PET equipped with a one-inch crystal.
The aim of this study was to evaluate the clinical value of 18-fluorodeoxyglucose (FDG) imaging with gamma-camera positron emission tomography (GCPET) equipped with a one-inch crystal for diagnosing lung lesions and determining the stage of non-small cell lung cancer (NSCLC) in regions with a high prevalence of inflammatory disease and tuberculosis. FDG-GCPET was used to examine 103 patients with suspected malignant lesions in the lung. The results of FDG-GCPET and conventional workup (CWU) including computed tomography (CT), ultrasonography and radionuclide bone scintigraphy were compared. The final diagnosis was based on the results of a histological analysis or follow-up of at least six months. The results showed 82 patients with malignant and 21 patients with benign lesions. If a lesion to background ratio > or = 2.0 was used as the threshold, then the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of FDG-GCPET for NSCLC were 93.9, 57.1, 86.4, 89.5 and 70.6%, respectively. In 36 patients who underwent open-chest surgery, the diagnostic positive values of FDG-GCPET and CT for lymph-node involvement were 85% (17/20) and 65% (13/20), respectively. The diagnostic sensitivity, specificity, accuracy, PPV and NPV of FDG imaging were 85, 81.3, 83.3, 85 and 81.3%, respectively compared to the CT values of 65, 75, 69.4, 76.5 and 63.2%, respectively (NS). For the evaluation of distant metastases, 31 true-positive patients were identified during the follow-up. FDG imaging correctly identified 28 patients compared to 25 by CWU. In conclusion, FDG imaging with GCPET equipped with a one-inch crystal revealed a high lesion detection capability but a low level of clinical effectiveness for differentiating between malignant and benign lesions in the lung in regions with a high prevalence of inflammatory disease and tuberculosis. For N and M staging of NSCLC, this method may provide additional data that are not available from the CWU.
Department of Nuclear Medicine, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou 310009, P.R. China. zhanhw@hotmail.com
Hong-Wei
HW
Zhan
Hai-Feng
HF
Cheng
Xiao-Juan
XJ
Ye
Chun-Lei
CL
Zhao
Hong
H
Zhang
Hong-Biao
HB
Liu
Gang-Qiang
GQ
He
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18