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.
Zhan
Hong-Wei
HW
Department of Nuclear Medicine, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou 310009, P.R. China. zhanhw@hotmail.com
Cheng
Hai-Feng
HF
Ye
Xiao-Juan
XJ
Zhao
Chun-Lei
CL
Zhang
Hong
H
Liu
Hong-Biao
HB
He
Gang-Qiang
GQ
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