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- Title
The clinical value of F-18 FDG PET/CT in differentiating malignant from benign lesions in pneumoconiosis patients.
- Authors
Choi, Eun Kyoung; Park, Hye Lim; Yoo, Ie Ryung; Kim, Seung Joon; Kim, Young Kyoon
- Abstract
<bold>Objectives: </bold>We reviewed PET/CT findings of pneumoconiosis and determined the ability of PET/CT to differentiate lung cancer from progressive massive fibrosis (PMF), and metastatic lymph nodes (LNs) from underlying reactive LN hyperplasia.<bold>Methods: </bold>This was a retrospective study of patients with pneumoconiosis and suspected lung cancer. Maximum standardized uptake value (SUVmax), long- and short-axis diameters (DL and DS), ratio of DL to DS (DL/S), and Hounsfield unit (HU) from the lung mass and mediastinal LNs were measured. The cutoff values of each parameter were obtained by ROC analysis, and we evaluated the diagnostic sensitivity.<bold>Results: </bold>Forty-nine pneumoconiosis patients were included. Eighty-three lung masses were detected, of which 42 were confirmed as lung cancer (23 squamous cell carcinomas, 12 adenocarcinomas, and 7 small cell carcinomas) and 41 were PMF. There were significant differences between lung cancer and PMF in terms of SUVmax, DS, DL/S, and HU (all p < 0.05). The sensitivity, specificity, and accuracy for diagnosis of lung cancer were 81.0%, 73.2%, and 77.1%, respectively, with an SUVmax cutoff value of 7.4; and 92.8%, 87.8%, and 90.4%, respectively, with a HU cutoff value of 45.5. Among the 40 LNs with available pathological results, 7 were metastatic. Metastatic LNs showed higher SUVmax, larger DS, and lower HU than benign lesions (all p < 0.05). The sensitivity, specificity, and accuracy for predicting metastatic LNs by PET/CT were 85.7%, 93.9%, and 92.5%, respectively.<bold>Conclusion: </bold>By applying PET and CT parameters in combination, the accuracy for differentiating malignant from benign lesions could be increased. PET/CT can play a central role in the discrimination of lung cancer and PMF.<bold>Key Points: </bold>• Lung cancer showed significantly higher SUVmax than PMF. • Lung cancer showed similar D L but longer D S , resulting in a smaller D L/S than PMF. • SUVmax demonstrated additive value in differentiating lung cancer from PMF, compared with HU alone.
- Subjects
LUNG cancer; SQUAMOUS cell carcinoma; SMALL cell carcinoma; MEDIASTINUM; LUNG tumors; HYPERPLASIA; RETROSPECTIVE studies; DIFFERENTIAL diagnosis; METASTASIS; LYMPH nodes; TUMOR classification; DUST diseases; RADIOPHARMACEUTICALS; PULMONARY fibrosis; RECEIVER operating characteristic curves; DEOXY sugars; DISEASE complications
- Publication
European Radiology, 2020, Vol 30, Issue 1, p442
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06342-1