title: Dual-time-point18F-FDG PET/CT in the diagnosis of solitary pulmonary lesions in a region with endemic granulomatous diseases.
abstract: OBJECTIVE
  Granulomatous diseases (GDs) can be metabolically active and indistinguishable from lung cancer on18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging. Evaluation of solitary pulmonary lesions remains a diagnostic challenge in regions with endemic GD. This study sought to determine the efficacy of dual-time-point (DTP)18F-FDG PET/computed tomography (CT) imaging in diagnosing solitary pulmonary lesions from such regions.
  
  
  METHODS
  A total of 50 patients with solitary pulmonary nodules or masses with confirmed histopathological diagnoses underwent DTP18F-FDG PET/CT imaging at 1 and 3 h after tracer injection. The maximum standardized uptake value (SUVmax) on early and delayed scans (SUV1hand SUV3h, respectively) and retention index (RI) were calculated for each pulmonary lesion. Receiver operating characteristic analysis was performed to evaluate the discriminating validity of the parameters.
  
  
  RESULTS
  There were 37 malignant and 13 benign solitary pulmonary lesions. Eight of the 13 (62 %) benign lesions were GDs. The sensitivity/specificity/accuracy of SUV1h, SUV3hand RI were 84/69/80 %, 84/85/84 %, and 81/54/74 %, respectively. SUV3hhad the best diagnostic performance, especially regarding specificity. The values of SUV1hand SUV3hwere significantly different between malignant lesions and GD, while the RI values of malignant lesions and GD were both high (18.6 ± 19.5 and 18.7 ± 15.3 %, respectively; P = not significant).
  
  
  CONCLUSIONS
  SUV3happeared to improve the diagnostic specificity of18F-FDG PET/CT in evaluating solitary pulmonary lesions from regions with endemic GD.
authors: Department of Nuclear Medicine, Tungs' Taichung MetroHarbor Hospital, No. 699, Sec. 8, Taiwan Blvd., Taichung, 435, Taiwan, ROC.
authors: Yu-Erh
authors: YE
authors: Huang
authors: Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong Dist., Kaohsiung, Taiwan, ROC.
authors: Yu-Jie
authors: YJ
authors: Huang
authors: Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine, No. 6, West Chia-Pu Road, Putz, Chiayi County, 613, Taiwan, ROC.
authors: Mary
authors: M
authors: Ko
authors: Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong Dist., Kaohsiung, Taiwan, ROC.
authors: Chien-Chin
authors: CC
authors: Hsu
authors: Department of Radiology, Asia University Hospital, Asia University, No. 222, Fuxin Road, Wufeng Dist., Taichung, 41354, Taiwan, ROC. xfroggykimo@gmail.com.
authors: Chih-Feng
authors: CF
authors: Chen
mesh_terms: D000368:Aged; D019353:Endemic Diseases; D005260:Female; D019788:Fluorodeoxyglucose F18; D006099:Granuloma / Q000150:complications*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D012372:ROC Curve; D013997:Time Factors
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-fluorodeoxyglucose; Positron emission tomography; Pulmonary; Standardized uptake value