Fluorodeoxyglucose-PET in characterizing solitary pulmonary nodules, assessing pleural diseases, and the initial staging, restaging, therapy planning, and monitoring response of lung cancer

https://doi.org/10.1016/j.rcl.2004.09.001Get rights and content

Section snippets

Solitary pulmonary nodules

A solitary pulmonary nodule (SPN) is usually defined as a lung lesion that is well defined, round or oval, smaller than 3.0 cm in diameter, and entirely surrounded by normal pulmonary parenchyma. Lesions that are larger than 3 cm are typically designated as masses and are usually malignant [1]. Solitary pulmonary nodules are a relatively common clinical finding and are seen in approximately 1 in 500 chest radiographs and computed tomograms [2]. Of the nearly 130,000 new SPNs found each year in

Lung cancer

Lung cancer is the leading cause of cancer worldwide and results in more than 1 million deaths each year [59]. This malignancy is the leading cause of cancer-related death in the United States, with a 5-year survival of only 15% [60]. Nearly 80% of patients with lung cancer are inoperable at the time of diagnosis. A major role of imaging studies is to diagnose the disease in early stages when the potential for cure is relatively high. In the past decade, significant advances in PET imaging seem

Pleural diseases

The pleura is a serous membrane composed of a single layer of mesothelial cells and consists of a visceral component, which covers the surface of the lung parenchyma, and a parietal layer, which overlies the inner surface of the thoracic cavity. The potential space between these two membranes is named the pleural space.

The pleura and pleural space can be affected by a multitude of pulmonary and extrapulmonary disorders, which can range from simple pleural effusions to fatal malignancies. These

First page preview

First page preview
Click to open first page preview
View PDF

References (145)

  • L. Hyde et al.

    Natural course of inoperable lung cancer

    Chest

    (1973)
  • R.H. Overholt et al.

    Primary cancer of the lung. A 42-year experience

    Ann Thorac Surg

    (1975)
  • T. Arita et al.

    Is it possible to differentiate malignant mediastinal nodes from benign nodes by size? Reevaluation by CT, transesophageal echocardiography, and nodal specimen

    Chest

    (1996)
  • C.E. Reed et al.

    Results of the American College of Surgeons Oncology Group Z0050 Trial: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer

    J Thorac Cardiovasc Surg

    (2003)
  • A.F.T. Verhagen et al.

    FDG-PET in staging lung cancer—how does it change the algorithm?

    Lung Cancer

    (2004)
  • C.J. Hoekstra et al.

    The value of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in the selection of patients with stage IIIA-N2 non-small cell lung cancer for combined modality treatment

    Lung Cancer

    (2003)
  • R.J. Cerfolio et al.

    The role of FDG-PET scan in staging patients with nonsmall cell carcinoma

    Ann Thorac Surg

    (2003)
  • I.F. Ciernik et al.

    Radiation treatment planning with an integrated positron emission and computer tomography (PET/CT): a feasibility study

    Int J Radiat Oncol Biol Phys

    (2003)
  • M.T. Munley et al.

    Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects

    Lung Cancer

    (1999)
  • J. Bradley et al.

    Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer

    Int J Radiat Oncol Biol Phys

    (2004)
  • R.J. Schilder et al.

    Phase II trial of induction high-dose chemotherapy followed by surgical resection and radiation therapy for patients with marginally resectable non-small cell carcinoma of the lung

    Lung Cancer

    (2000)
  • D. Ost et al.

    Clinical practice. The solitary pulmonary nodule

    N Engl J Med

    (2003)
  • S.R. Cummings et al.

    Estimating the probability of malignancy in solitary pulmonary nodules. A Bayesian approach

    Am Rev Respir Dis

    (1986)
  • W.R. Webb

    Radiologic evaluation of the solitary pulmonary nodule

    AJR Am J Roentgenol

    (1990)
  • D.F. Yankelevitz et al.

    Does 2-year stability imply that pulmonary nodules are benign?

    AJR Am J Roentgenol

    (1997)
  • S.S. Gambhir et al.

    Analytical decision model for the cost-effective management of solitary pulmonary nodules

    J Clin Oncol

    (1998)
  • J.S. Klein et al.

    Transthoracic needle biopsy: an overview

    J Thorac Imaging

    (1997)
  • R.C. Yung

    Tissue diagnosis of suspected lung cancer: selecting between bronchoscopy, transthoracic needle aspiration, and resectional biopsy

    Respir Care Clin N Am

    (2003)
  • Y. Tsushima et al.

    Analysis models to assess cost effectiveness of the four strategies for the work-up of solitary pulmonary nodules

    Med Sci Monit

    (2004)
  • N.C. Gupta et al.

    Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro-2-deoxy-D-glucose

    Radiology

    (1992)
  • M.K. Gould et al.

    Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions—a meta-analysis

    JAMA

    (2001)
  • V.J. Lowe et al.

    Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities

    J Nucl Med

    (1994)
  • N.C. Gupta et al.

    Probability of malignancy in solitary pulmonary nodules using fluorine-18-FDG and PET

    J Nucl Med

    (1996)
  • G. Ruiz-Hernandez et al.

    [Positron emission tomography using 18-FDG-PET in radiologically indeterminate pulmonary lesions]

    Med Interna

    (2004)
  • N.V. Ghesani et al.

    Fluorodeoxyglucose positron emission tomography excludes pericardial metastasis by recurrent lung cancer

    Clin Nucl Med

    (2003)
  • D. Ost et al.

    Management strategies for the solitary pulmonary nodule

    Curr Opin Pulm Med

    (2004)
  • G.J. Herder et al.

    The performance of (18)F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules

    Eur J Nucl Med Mol Imaging

    (2004)
  • S.M.B. Bakheet et al.

    F-18-FDG uptake in tuberculosis

    Clin Nucl Med

    (1998)
  • S.M. Bakheet et al.

    F-18 fluorodeoxyglucose chest uptake in lung inflammation and infection

    Clin Nucl Med

    (2000)
  • H.A. Jones et al.

    In vivo measurement of neutrophil activity in experimental lung inflammation

    Am J Respir Crit Care Med

    (1994)
  • H. Zhuang et al.

    Intense F-18 fluorodeoxyglucose uptake caused by Mycobacterium avium intracellulare infection

    Clin Nucl Med

    (2001)
  • G. Mackie

    F-18 fluorodeoxyglucose positron emission tomographic imaging of cytomegalovirus pneumonia

    Clin Nucl Med

    (2004)
  • H. Zhuang et al.

    Pulmonary Clostridium perfringens infection detected by FDG positron emission tomography

    Clin Nucl Med

    (2003)
  • P.J. Lewis et al.

    Uptake of fluorine-18-fluorodeoxyglucose in sarcoidosis

    J Nucl Med

    (1994)
  • J.Q. Yu et al.

    Demonstration of increased FDG activity in Rosai-Dorfman disease on positron emission tomography

    Clin Nucl Med

    (2004)
  • M.J. Yun et al.

    F-18FDG uptake in the large arteries—a new observation

    Clin Nucl Med

    (2001)
  • J. Kung et al.

    Intense fluorodeoxyglucose activity in pulmonary amyloid lesions on positron emission tomography

    Clin Nucl Med

    (2003)
  • S. Chiang et al.

    Potential false-positive FDG PET imaging caused by subcutaneous radiotracer infiltration

    Clin Nucl Med

    (2003)
  • P. Lin et al.

    Fluorine-18 FDG dual-head gamma camera coincidence imaging of radiation pneumonitis

    Clin Nucl Med

    (2000)
  • H. Zhuang et al.

    Chest tube insertion as a potential source of false-positive FDG-positron emission tomographic results

    Clin Nucl Med

    (2002)

    • Cited by (67)

    • Metastatic Seeding Attacks Bone Marrow, Not Bone: Rectifying Ongoing Misconceptions

      2019, PET Clinics

    • Diagnosis of recurrence and assessment of post-recurrence survival in patients with extracranial non-small cell lung cancer evaluated by 18F-FDG PET/CT

      2013, Lung Cancer
      Citation Excerpt :

      However, we also know that CT has only a limited diagnostic capacity when it comes to distinguishing between fibrotic tissue, or scar and tumoral tissue, and post-radiotherapy pneumonitis [7,8]. Although the superiority of metabolic imaging, like FDG PET or PET/CT over structural imaging for the staging of NSCLC has been established [9–11], the reports on its contribution to the diagnosis of recurrence and to the clinical impact on patients management are scarce [12–15]. However, in a very recent report, Gregory et al. [16] have established the relationship between the FDG PET/CT at staging and survival.

    • Rare Pleural Tumors

      2013, Clinics in Chest Medicine
      Citation Excerpt :

      Currently, PET may be best used to exclude another primary site of tumor as part of the evaluation of a suspected primary pleural tumor.35,36 On fluorodeoxyglucose (FDG) PET-CT, pleural involvement may appear as localized, focal, or patchy FDG uptake, but this does not necessarily discern primary from metastatic disease, or local spread of primary lung carcinoma.37–39 Some studies suggest that FDG PET-CT may be useful when distinguishing benign from malignant pleural tumors, with sensitivity, specificity, and negative predictive values between 88% and 96%.36,40

    • Comparative study of solitary thin-walled cavity lung cancer with computed tomography and pathological findings

      2012, Lung Cancer
      Citation Excerpt :

      Meanwhile, tumor tissues irregularly grew along the cavity wall and induced asymmetric thickening of the wall. The examinations of chest radiography and CT are commonly used for the clinical diagnosis of lung cancer [15,16]. Most cavitary lung cancers usually present typical radiographic findings such as irregular margins and thick-walled cavities.

    • Positron Emission Tomography Imaging

      2012, Clinical Respiratory Medicine: Fourth Edition

    • Is a selective brain <sup>18</sup>F-FDG PET/CT study profitable in patients with small cell lung cancer?

      2012, Revista Espanola de Medicina Nuclear e Imagen Molecular
    View all citing articles on Scopus
    View full text
    Copyright © 2004 Elsevier Inc. All rights reserved.