The role of positron emission tomography/computed tomography in the diagnosis of pleural diseases.
BACKGROUND
The aim of the study was to assess the role of F-18 fluoro-2-D-deoxyglucose positron emission tomography ( (18)FDG-PET)/computed tomography (CT) in patients with undiagnosed pleural diseases and to compare the findings with those of invasive diagnostic procedures.


METHODS
The study included 83 patients with pleural lesions (63 with pleural effusion; 20 with pleural thickening) on CT scan performed between November 2005 and December 2007. The study group consisted of 63 males and 20 females; their median age was 47 years. PET-CT scan was performed for all patients before surgery. A maximum standard uptake value greater than 3.0 was accepted as positive for malignancy. For histopathological diagnosis, video-assisted thoracoscopic surgery was performed in 76 patients and a mini-thoracotomy was performed for the remaining 7 patients.


RESULTS
Postoperative histopathological examination revealed malignancy in 44 cases, 25 of which were malignant mesothelioma; the remaining 39 cases were benign. There were no false negative results, but two false positive results (tuberculosis). PET-CT scanning had 100 % sensitivity, 94.8 % specificity and 97.5 % accuracy.


CONCLUSIONS
Our study suggests that PET-CT may be an effective tool for the differentiation of benign and malignant pleural diseases. We believe that PET/CT may prevent redundant surgical procedures in young patients who are SUVmax negative.
Orki
A
A
Thoracic Surgery, Maltepe University School of Medicine, Istanbul, Turkey. alpayorki@yahoo.com
Akin
O
O
Tasci
A E
AE
Ciftci
H
H
Urek
S
S
Falay
O
O
Kutlu
C A
CA
D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis*; D010996:Pleural Effusion / Q000175:diagnosis / Q000473:pathology; D010997:Pleural Neoplasms / Q000175:diagnosis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014396:Tuberculosis, Pleural / Q000175:diagnosis
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18