18F-FDG Accumulation with PET for Differentiation Between Benign and Malignant Lesions in the Thorax
Yoshiki Demura, MD1,
Tatsuro Tsuchida, MD2,
Takeshi Ishizaki, MD3,
Shiro Mizuno, MD1,
Yoshitaka Totani, MD1,
Shingo Ameshima, MD1,
Isamu Miyamori, MD1,
Masato Sasaki, MD4 and
Yoshiharu Yonekura, MD5
1 Third Department of Internal Medicine, Fukui Medical University, Fukui, Japan
2 Department of Radiology, Fukui Medical University, Fukui, Japan
3 Department of Fundamental Nursing, Fukui Medical University, Fukui, Japan
4 Second Department of Surgery, Fukui Medical University, Fukui, Japan
5 Biomedical Imaging Research Center, Fukui Medical University, Fukui, Japan
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FIGURE 1. Changes in 18F-FDG accumulation (SUV) between early and delayed imaging in primary lesions of malignant lesion group (mostly lung cancer) (A), benign disease group (group 9) (B), and granulomatous disease group (group 10) (C). Significant increases of SUV in A and C and significant decrease of SUV in B were observed. Bars indicate mean ± SD. *P < 0.05.
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FIGURE 2. Comparison of SUV levels with 18F-FDG PET. (A) Early imaging. (B) Delayed imaging. (C) RI in thoracic lesions. Significant correlations were observed between SUV levels and degree of cell differentiation in lung cancer. For adenocarcinoma, squamous cell carcinoma, and undifferentiated carcinoma, 18F-FDG accumulations in delayed images better reflected degree of cell differentiation than that in early images. For SUV RI, cell differentiation was better reflected and benign disease group (group 9) was significantly differentiated from other groups. Results are expressed as mean ± SD.
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FIGURE 3. Patient with well-differentiated lung adenocarcinoma (2.2 x 2.0 cm). (A) CT image shows nodule in right lung. (B) 18F-FDG PET early image shows faint accumulation in nodule (SUV = 2.40). (C) 18F-FDG PET delayed image shows increased hot accumulation in nodule (SUV = 3.00) along with good visualization. Nodule was not detected by 201Tl SPECT (image not shown).
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FIGURE 4. Patient with posterior mediastinal schwannoma (3.5 x 2.2 cm). (A) CT image shows nodule in left thorax. (B) 18F-FDG PET early image shows hot accumulation in nodule (SUV = 2.80). (C) 18F-FDG PET delayed image shows decreased hot accumulation in nodule (SUV = 1.70). Nodule was not detected by 201Tl SPECT (image not shown).
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FIGURE 5. Comparison of results of 201Tl SPECT. (A) Early imaging. (B) Delayed imaging. (C) RI in thoracic lesions. No significant correlations were observed between results and degree of cell differentiation in lung cancer. As for RI of 201Tl SPECT, only benign disease group (group 9) was significantly differentiated from others. Results are expressed as mean ± SD. *P < 0.05 vs. other groups, excluding group 4.
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FIGURE 6. (A) Correlation between SUV levels of lymph node metastases and primary tumors in 18F-FDG PET early imaging of lung cancer patients with nodal involvement. Correlation between SUV levels of lymph node metastases and primary tumors was found (y = 0.418x + 2.113; r = 0.601; P = 0.0161). (B) Correlation between SUV levels of lymph node metastases and primary tumors in 18F-FDG PET delayed imaging of lung cancer patients with nodal involvement. Correlation between SUV levels of lymph node metastases and primary tumors was found (y = 0.482x + 1.894; r = 0.651; P = 0.0071). (C) Correlation between RI-SUV (%) of lymph node metastases and primary tumors in 18F-FDG PET early imaging of lung cancer patients with nodal involvement. Good correlation between RI-SUV (%) of lymph node metastases and primary tumors was found (y = 0.917x + 2.180; r = 0.895; P < 0.0001). Result in C showed best correlation among 3 graphs.
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Copyright © 2003 by the Society of Nuclear Medicine.
