HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yi, C. A Articles by Chung, M. J. Search for Related Content PubMed PubMed Citation Articles by Yi, C. A Articles by Chung, M. J.

Tissue Characterization of Solitary Pulmonary Nodule: Comparative Study Between Helical Dynamic CT and Integrated PET/CT

¹ Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; ² Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; ³ Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and ⁴ Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: For correspondence or reprints contact: Kyung Soo Lee, MD, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea. E-mail: kyungs.lee{at}samsung.com

Recent advances in the technology of helical multidetector CT allow precise evaluations of nodule hemodynamics. In addition, the efficacy of tissue characterization has improved, and now sensitivity and specificity of >90% are achieved. Moreover, the efficacy of PET for the tissue characterization of solitary pulmonary nodules (SPNs) has also become of importance. The purpose of this study was to compare the diagnostic accuracy of helical dynamic (HD) CT (HDCT) and integrated PET/CT for pulmonary nodule characterization. Methods: One hundred nineteen patients with an SPN underwent both HDCT (unenhanced scans, followed by series of images at 30, 60, 90, 120 s and at 5 and 15 min after intravenous injection of contrast medium) and integrated PET/CT. On HDCT, a nodule was regarded as malignant with a net enhancement of 25 Hounsfield units (HU) and a washout of 5–31 HU. On integrated PET/CT, nodules were considered malignant with a 3.5 maximum standardized uptake value and an ¹⁸F-FDG uptake greater than that of mediastinal structures. The sensitivity, specificity, and accuracy of the 2 modalities for malignancy were compared using the McNemar test. Results: There were 79 malignant and 40 benign nodules. The sensitivity, specificity, and accuracy for malignancy on HDCT were 81% (64/79 nodules), 93% (37/40), and 85% (101/119), respectively, whereas those on integrated PET/CT were 96% (76/79), 88% (35/40), and 93% (111/119), respectively (P = 0.008, 0.727, and 0.011, respectively). All malignant nodules were interpreted correctly on either HDCT or PET/CT. Conclusion: Integrated PET/CT is more sensitive and accurate than HDCT for the malignant nodule characterization; therefore, PET/CT may be performed as the first-line evaluation tool for SPN characterization. Because HDCT has high specificity and acceptable sensitivity and accuracy, it may be a reasonable alternative for nodule characterization when PET/CT is unavailable.

Key Words: lung neoplasms, diagnosis • lung neoplasms, CT • lung neoplasms, PET

Related articles in JNM:

This Month in JNM

JNM 2006 47: 7a-8a. [Full Text]  

This article has been cited by other articles:

				S. Satoh, Y. Kitazume, S. Ohdama, Y. Kimula, S. Taura, and Y. Endo Can Malignant and Benign Pulmonary Nodules Be Differentiated with Diffusion-Weighted MRI? Am. J. Roentgenol., August 1, 2008; 191(2): 464 - 470. [Abstract] [Full Text] [PDF]

				G. Veronesi, M. Bellomi, U. Veronesi, G. Paganelli, P. Maisonneuve, P. Scanagatta, F. Leo, G. Pelosi, L. Travaini, C. Rampinelli, et al. Role of Positron Emission Tomography Scanning in the Management of Lung Nodules Detected at Baseline Computed Tomography Screening Ann. Thorac. Surg., September 1, 2007; 84(3): 959 - 966. [Abstract] [Full Text] [PDF]

				K. S. Lee, C. A. Yi, S. Y. Jeong, Y. J. Jeong, S. Kim, M. J. Chung, H. Y. Kim, Y. K. Kim, and K. H. Lee Solid or Partly Solid Solitary Pulmonary Nodules: Their Characterization Using Contrast Wash-In and Morphologic Features at Helical CT Chest, May 1, 2007; 131(5): 1516 - 1525. [Abstract] [Full Text] [PDF]

				S. Chong, K. S. Lee, B.-T. Kim, J. Y. Choi, C. A Yi, M. J. Chung, D.-K. Oh, and J.-Y. Lee Integrated PET/CT of Pulmonary Neuroendocrine Tumors: Diagnostic and Prognostic Implications Am. J. Roentgenol., May 1, 2007; 188(5): 1223 - 1231. [Abstract] [Full Text] [PDF]

				Y. J. Jeong, C. A. Yi, and K. S. Lee Solitary Pulmonary Nodules: Detection, Characterization, and Guidance for Further Diagnostic Workup and Treatment Am. J. Roentgenol., January 1, 2007; 188(1): 57 - 68. [Abstract] [Full Text] [PDF]

				J. Czernin, M. Allen-Auerbach, and H. R. Schelbert Improvements in Cancer Staging with PET/CT: Literature-Based Evidence as of September 2006 J. Nucl. Med., January 1, 2007; 48(1_suppl): 78S - 88S. [Abstract] [Full Text] [PDF]