RT Journal Article
SR Electronic
T1 The value of differentiation malignant solitary pulmonary nodules in a digital PET/CT: Impact of image reconstructions on diagnostic performance
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1440
OP 1440
VO 62
IS supplement 1
A1 zou, jinhai
A1 xing, yu
A1 han, yu
A1 zhan, yingying
A1 bao, jing
A1 liang, chen
A1 zuo, chao
YR 2021
UL http://jnm.snmjournals.org/content/62/supplement_1/1440.abstract
AB 1440Objectives: To evaluate the diagnostic performance of Bayesian Personalized Likelihood (BPL) reconstruction in digital PET/CT on solitary pulmonary nodules (SPNs). Methods: Between September 2019 and December 2020, patients with SPNs undergoing 18F FDG PET/CT were retrospectively included, with histological confirmation of malignancy or histological/imaging follow-up confirmation of benignity. The SPNs were 5-23mm. Two blinded readers independently classified SPNs uptake on both BPL and non-BPL, based on 4-point scales (1 none; 2 less than or equal to liver; 3 larger than liver, but less than or equal to 2 times liver; 4 larger than 2 times liver), and PET/CT score ≥4 was diagnosed as malignant. Receiver-operator characteristic (ROC) curves were assessed, and the areas under the ROC curve (AUC) and positive likelihood ratios (LRs) for BPL and non-BPL PET were compared. Results: One hundred and twenty-five subjects with 56.8 % (71/125) malignant SPNs were included. The average size was 13 mm. BPL increased PET/CT scale in 31.2% (39/125) SPNs, of which 11 (8.8%) SPNs were diagnosed as malignant from benign due to the non-BPL. The AUC of SUVmax-based malignant SPNs differentiation was 0.883 (95%CI: 0.820-0.946) for BPL and 0.872 (95%CI: 0.803-0.941) for non-BPL (p=0.41). The optimum SPN SUVmax cut-off value for BPL was 4.39 g/ml (sensitivity 0.91, specificity 0.76, PPV 0.89, NPV 0.62), and for non-BPL 2.86 g/ml (sensitivity 0.93, specificity 0.74, PPV 0.86, NPV 0.56). However, positive LRs for BPL and non-BPL results for rating malignancy were 6.24 and 4.71, respectively. Conclusions: Malignant results on BPL reconstruction were more predictive of malignancy of SPNs than non-BPL, these make physicians more confident in malignant SPNs final diagnosis.