title: Preliminary study on the correlation between grading and histology of solitary pulmonary nodules and contrast enhancement and [18F]fluorodeoxyglucose standardised uptake value after evaluation by dynamic multiphase CT and PET/CT.
abstract: OBJECTIVE
  To evaluate whether the histology and grading of solitary pulmonary nodules (SPNs) correlated with the results of dynamic multiphase multidetector CT (MDCT) and the [(18)F]fluorodeoxyglucose standardised uptake value (SUV) in 30 patients.
  
  
  METHODS
  Chest x-rays of 270 patients with incidentally detected SPNs were retrospectively evaluated. Thirty patients with histologically proven SPNs were enrolled. On MDCT and positron emission tomography (PET)/CT images, two experts measured the density of nodules in all perfusion phases and the SUV. Net enhancement (NE) was calculated by subtracting peak pre-contrast density from peak post-contrast density. The Pearson test was used to correlate nodule NE, SUV, grading, histology and diameter.
  
  
  RESULTS
  Of the 30 malignant SPNs, six were classified as G1 (median NE, 31.5 Hounsfield units (HU); median SUV, 4.8 units), 15 were classified as G2 (median NE, 49 HU; median SUV, 6 units), and nine were classified as G3 (median NE, 32 HU; median SUV, 4.5 units). A highly negative correlation was found in G3 SPNs between NE and the corresponding diameters (r=-0.834; p=0.00524). NE increased with the increase in diameter (r=0.982; p=0.284). SUV increased as the SPN diameter increased (r=0.789; p=0.421). NE and SUV were higher in G2 than G1 SPNs, and lower in G2 than G3 SPNs (r=0.97; p=0.137).
  
  
  CONCLUSIONS
  The significant correlation in dedifferentiated (G3) SPNs between NE and diameter (r=-0.834; p=0.00524) supports the theory that stroma and neoangiogenesis are fundamental in SPN growth. The highly negative correlation between NE and diameter demonstrates a net decrease in perfusion despite an increase in dimension. The multidisciplinary approach used herein may result in a more precise prognosis and consequently a better therapeutic outcome, particularly in patients with undifferentiated lung cancer.
authors.affiliation: Department of Clinical Internal Medicine F Magrassi-L Lanzara, Science Section of Radiology, Second University of Studies of Naples, Naples, Italy. salvatore.cappabianca@unina2.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cappabianca
authors.forename: Annamaria
authors.initials: A
authors.lastname: Porto
authors.forename: Mario
authors.initials: M
authors.lastname: Petrillo
authors.forename: Barbara
authors.initials: B
authors.lastname: Greco
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Ronza
authors.forename: Francesca
authors.initials: F
authors.lastname: Setola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Matteo
authors.forename: Roberto
authors.initials: R
authors.lastname: Muto
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: De Rimini
authors.forename: Sergio
authors.initials: S
authors.lastname: Piccolo
authors.forename: Mara
authors.initials: M
authors.lastname: Catalano
authors.forename: Pietro
authors.initials: P
authors.lastname: Muto
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Rosa
authors.forename: Enrica
authors.initials: E
authors.lastname: Barra
authors.forename: Ilaria
authors.initials: I
authors.lastname: De Rosa
authors.forename: Francesca
authors.initials: F
authors.lastname: Antinolfi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Antinolfi
authors.forename: Mario
authors.initials: M
authors.lastname: Caputi
authors.forename: Luca
authors.initials: L
authors.lastname: Brunese
authors.forename: Roberto
authors.initials: R
authors.lastname: Grassi
authors.forename: Antonio
authors.initials: A
authors.lastname: Rotondo
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18