Limited diagnostic value of Dual-Time-Point (18)F-FDG PET/CT imaging for classifying solitary pulmonary nodules in granuloma-endemic regions both at visual and quantitative analyses.
OBJECTIVE
This study is aimed to compare the diagnostic power of using quantitative analysis or visual analysis with single time point imaging (STPI) PET/CT and dual time point imaging (DTPI) PET/CT for the classification of solitary pulmonary nodules (SPN) lesions in granuloma-endemic regions.


METHODS
SPN patients who received early and delayed (18)F-FDG PET/CT at 60min and 180min post-injection were retrospectively reviewed. Diagnoses are confirmed by pathological results or follow-ups. Three quantitative metrics, early SUVmax, delayed SUVmax and retention index(the percentage changes between the early SUVmax and delayed SUVmax), were measured for each lesion. Three 5-point scale score was given by blinded interpretations performed by physicians based on STPI PET/CT images, DTPI PET/CT images and CT images, respectively. ROC analysis was performed on three quantitative metrics and three visual interpretation scores.


RESULTS
One-hundred-forty-nine patients were retrospectively included. The areas under curve (AUC) of the ROC curves of early SUVmax, delayed SUVmax, RI, STPI PET/CT score, DTPI PET/CT score and CT score are 0.73, 0.74, 0.61, 0.77 0.75 and 0.76, respectively. There were no significant differences between the AUCs in visual interpretation of STPI PET/CT images and DTPI PET/CT images, nor in early SUVmax and delayed SUVmax. The differences of sensitivity, specificity and accuracy between STPI PET/CT and DTPI PET/CT were not significantly different in either quantitative analysis or visual interpretation.


CONCLUSIONS
In granuloma-endemic regions, DTPI PET/CT did not offer significant improvement over STPI PET/CT in differentiating malignant SPNs in both quantitative analysis and visual interpretation.
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: chensongchina@163.com.
Song
S
Chen
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: lixuenacmunm@163.com.
Xuena
X
Li
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: chenmj2015@hotmail.com.
Meijie
M
Chen
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: yinyf-2001@163.com.
Yafu
Y
Yin
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: anna_lee2011@163.com.
Na
N
Li
Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 North Nanjing Street, Heping District, Shenyang City, Liaoning Province, 110001, PR China. Electronic address: ymli2001@163.com.
Yaming
Y
Li
D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006099:Granuloma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods* / Q000592:standards; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods* / Q000592:standards; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Dual-time point imaging; PET/CT; Solitary pulmonary nodules