Noninvasive Differential Diagnosis of Pulmonary Nodules Using the Standardized Uptake Value Index.
OBJECTIVE
We previously showed that the standardized uptake value (SUV) index, which was defined as the ratio of the maximum SUV of the tumor to mean SUV of the liver, was a surrogate marker of lung cancer aggressiveness. In this study of patients with pulmonary nodules (PNs), we explored whether the SUV index could be used to differentiate small malignant from small benign PNs.


METHODS
A total of 284 patients with solitary PNs ≤2 cm in size underwent positron emission tomography/computed tomography and surgery. The associations between pathological findings and clinical factors were evaluated.


RESULTS
The median SUV indices of lung cancer, metastatic PNs and benign nodules were 1.2, 1.5, and 0.6, respectively (P <0.01). A SUV index cut-off value of 1.2 was used to differentiate benign from malignant nodules. When patients were grouped according to SUV index cut-off values of <1.2 or ≥1.2, the following cases were false-negative: lung adenocarcinoma (P <0.01), kidney as primary site (P <0.01), and metastatic PNs with long disease-free survival (P = 0.02).


CONCLUSIONS
As a noninvasive diagnostic marker, the SUV index was found to be useful for differentiating benign from malignant small PNs.
Departments of Thoracic Surgery, Yamagata Prefectural Central Hospital,Yamagata, Yamagata, Japan.
Satoshi
S
Shiono
Naoki
N
Yanagawa
Masami
M
Abiko
Toru
T
Sato
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011013:Pneumonectomy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18