The role of FDG PET-CT in differential diagnosis of pleural pathologies.
OBJECTIVE
This study has aimed to evaluate the impact of (F18) Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) in the differential diagnosis of malignant and benign pleural lesions in patients with suspected malignant pleural mesothelioma (MPM).


METHODS
Fifty patients (32 females, 18 males; age range 24-79 years) with pleural thickening, fluid, plaques or calcification on previous CT scan were examined with FDG PET-CT. PET-CT imaging was obtained 1 h after FDG injection. In 12 patients, delayed imaging from the thoracic region was performed 2 h after injection. FDG uptake was evaluated visually and semiquantitively using standardized uptake value (SUV). FDG PET-CT findings were compared with histopathologic diagnosis.


RESULTS
Thirty-nine patients had increased FDG uptake in pleural lesions but PET-CT results were negative in 11 patients. When compared with histopathological results in FDG positive group, 34 patients had MPM, 5 had benign pathology; in FDG negative group 8 patients had benign pathology, 3 had MPM. Of patients with delayed imaging, 9 showed increased SUV but 3 had a decreased SUV on delayed images. Increased SUV group had 4 MPM, 5 benign pathology (3 chronic granulomatous inflammation, 2 benign asbestotic plaque). Decreased SUV group all had benign pathology (fibrosis, chronic inflammation, myofibrosis).


CONCLUSIONS
FDG PET-CT is a useful imaging modality in differential diagnosis of malignant and benign pleural lesions. Delayed imaging seems to be useful if there is a decrease in SUV suggesting a benign pathology but does not seem to contribute to the differential diagnosis if the SUV is increased.
Department of Nuclear Medicine, University of Gaziantep, School of Medicine, Gaziantep, Turkey. umutelboga@hotmail.com
U
U
Elboga
M
M
Yılmaz
M
M
Uyar
Y
Y
Zeki Çelen
K
K
Bakır
O
O
Dikensoy
D000328:Adult; D000368:Aged; D001195:Asbestosis / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006099:Granuloma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D064847:Multimodal Imaging; D010995:Pleural Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013030:Spain; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18