PROSPECTIVE INVESTIGATION OF POSITRON-EMISSION-TOMOGRAPHY IN LUNG NODULES

Purpose: Solitary pulmonary nodules (SPNs) are commonly identified by chest radiographs and computed tomography (CT). Biopsies are often per formed to evaluate the nodules further. An accurate, noninvasive diagn ostic test could avoid the morbidity and costs of invasive tissue samp ling. We evaluated the ability of fluorine-18 deoxyglucose positron em ission tomography (FDG-PET) to discriminate between benign and maligna nt pulmonary nodules in a prospective, multicenter trial. Methods: Eig hty-nine patients who had newly identified indeterminate SPNs on chest radiographs and CT were evaluated with FDG-PET. PET data were analyze d semiquantitatively by calculating standardized uptake values (SUVs) as an index of FDG accumulation and also by a visual scoring method. P ET results were compared with pathology results. Results: Sixty SPNs w ere malignant and 29 were benign. Using SUV data, PET had an overall s ensitivity and specificity for detection of malignant nodules of 92% a nd 90%, Visual analysis provided a slightly higher, but not statistica lly significant, sensitivity of 98% and lower specificity of 69%. For SPNs less than or equal to 1.5 cm (34 of 89), the sensitivity and spec ificity of SUV and visual analysis were 80% and 95% and 100% and 74%, respectively. Conclusion: FDG-PET can accurately, characterize indeter minate SPNs. PET imaging provides a noninvasive method to evaluate ind eterminate SPNs, which can reduce the need for invasive tissue biopsy. (C) 1998 by American Society of Clinical Oncology.