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The Journal of Nuclear Medicine Vol. 31 No. 12 1927-1932
© 1990 by Society of Nuclear Medicine
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Differential Diagnosis of Lung Tumor with Positron Emission Tomography: A Prospective Study

Kazuo Kubota, Taiju Matsuzawa, Takehiko Fujiwara, Masatoshi Ito, Jun Hatazawa, Kiichi Ishiwata, Ren Iwata and Tatsuo Ido

Department of Radiology and Nuclear Medicine, The Research Institute for Tuberculosis and Cancer, and Cyclotron Radioisotope Center, Tohoku University, Sendai, Japan

Correspondence: For reprints contact: Kazuo Kubota, MD, Department of Radiology and Nuclear Medicine, The Research Institute for Tuberculosis and Cancer, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai 980, Japan.

ABSTRACT

To predict the nature of non-calcifying lung tumors, we performed a prospective study of 46 cases with L-[methyl 11C]methionine (MET, 24 cases) and 18F-fluorodeoxyglucose (FDG, 22 cases) using positron emission tomography (PET). Mean tumor/muscle radioactivity ratios are 5.3 ± 2.0 (n = 14) for malignant and 1.9 ± 0.9 (n = 10) for benign with MET (p < 0.001), and 4.4 ± 2.2 (n = 12) and 1.5 ± 0.3 (n = 10), respectively, with FDG (p < 0.001). The ratios indicate that malignant tumors have higher metabolic demand than benign lesions. Tumors less than 1 cm in diameter were difficult to accurately evaluate due to PET resolution. Compared to the diagnosis at pathology, the MET study showed a sensitivity of 93% (13/14), a specificity of 60% (6/10), and an accuracy of 79% (19/24). The FDG study showed 83% (10/12), 90% (9/10), 86% (19/22), respectively. No significant differences were observed between the two tracers. This study suggests that PET studies using either MET or FDG may be very useful for the differential diagnosis of lung tumors.




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