[Development of a predicting model to estimate the probability of malignancy of solitary pulmonary nodules].
OBJECTIVE
To evaluate the role of (18)F-FDG PET/CT in characterizating solitary pulmonary nodule (SPN) and bone lesions.


METHODS
105 patients with a SPN smaller than 30 mm in axial diameter were recruited for this study. PET/CT images were obtained 60 min after intravenous injection of (18)F-FDG. Logistic regression analysis was performed to identify clinical predictors of SPN malignancy including age, sex, smoking history, malignant history, family history, symptoms, size, location, CT appearances, (18)F-FDG uptake, and to develop a clinical prediction model to estimate the probability of malignancy in the patients with SPN. The model fit was evaluated and the area under curve (AUC) of receiver operating characteristic (ROC) was used to evaluate the power of the model.


RESULTS
The logistic regression analysis indicated that male, a positive smoking history, older age, larger nodule diameter, nodule with specula and nodule with high (18)F-FDG uptake were more likely to have malignant SPN. The clinical prediction model is described by the following equation: Logit(P) = -8.722 + 2.448 (gender) + 2.023(smoking) + 0. 851(age) + 1.057 (diameter) + 2.432 (spiculation) + 1.502 (FDG uptake). The AUC of the model was 0.892 (95% confidence interval 0.817 - 0.941). The prediction model had high accuracy in predicting malignant SPN, with 90.2%, 84.1 % and 87.6% sensitivity, specificity and accuracy respectively when the cut off value was set at 0.67.


CONCLUSIONS
The prediction model is valid in predicting the probability of malignant SPN.
Rong
R
Tian
Ming-gang
MG
Su
Ye
Y
Tian
Fang-lan
FL
Li
An-ren
AR
Kuang
D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18