دورية أكاديمية
Granulomatous disease: is it a nuisance or an asset during PET/computed tomography evaluation of lung cancers?
| العنوان: | Granulomatous disease: is it a nuisance or an asset during PET/computed tomography evaluation of lung cancers? |
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| المؤلفون: | Chundru S; Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073-6769, USA., Wong CY, Wu D, Balon H, Palka J, Chang CY, Gaskill M, Cheng CY, Huang WS, Fink-Bennett D |
| المصدر: | Nuclear medicine communications [Nucl Med Commun] 2008 Jul; Vol. 29 (7), pp. 623-7. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8201017 Publication Model: Print Cited Medium: Print ISSN: 0143-3636 (Print) Linking ISSN: 01433636 NLM ISO Abbreviation: Nucl Med Commun Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Lippincott Williams & Wilkins Original Publication: London : Chapman and Hall in association with the British Nuclear Medicine Society, c1980- |
| مواضيع طبية MeSH: | Granulomatous Disease, Chronic/*diagnosis , Positron-Emission Tomography/*methods , Solitary Pulmonary Nodule/*diagnosis , Tomography, X-Ray Computed/*methods, Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/diagnosis ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique |
| مستخلص: | Objectives: To evaluate combined PET-computed tomography (CT) criteria for differentiating between granulomatous disease (GD) and malignancy (CA) in oncologic PET-CT studies. Methods: Sixty-two patients who were referred for fluoro-2-deoxyglucose (FDG) PET-CT evaluation of pulmonary lesion(s) without a history of concurrent infection were studied. PET-CT was performed 1.5 h after intravenous administration of 555 MBq 18F-FDG in the fasting state with oral contrast. Combined PET-CT criteria including (i) calcifications (Ca2+) within lymph nodes, (ii) Ca2+ in lung nodules, (iii) liver and/or spleen Ca2+, (iv) locations of lung lesion(s), (v) hilar FDG uptake, (vi) comparison of lung versus maximum mediastinal FDG uptake, (vii) lymph node uptake not in the most probable lymphatic drainage pathway from a particular lung lesion, and (viii) extra pulmonary abnormal FDG uptake were each assigned a numerical score (0-3) with progressively higher score and sum of scores toward the increasing likelihood of GD. These patients either had pathological confirmation by biopsy/resection or were followed radiographically for a period of 2 years (CA=13; GD=49). Discriminant analysis was performed on all the above criteria with this gold standard. Simple t-test and box plot analysis were also performed on the summation of the scores (from 0 in CA to 13 in GD). Results: When all eight criteria were entered into discriminant analysis, the combined PET-CT criteria classified correctly 71% of patients with a sensitivity of 65% and specificity of 92% for GD. The most significant discriminating criterion was FDG uptake in the lung lesion(s) less than maximum mediastinal uptake (P=0.01). The sum scores in GD and CA were significantly different (4.9+/-2.4 vs. 3.2+/-1.5, respectively, P=0.014). Box plots showed a clear separation at a cut-off value of around 3.5. Conclusion: Results show that the set of combined PET-CT criteria are highly specific for GD, which is not necessarily a nuisance during oncologic evaluation. Knowledge of these criteria may attribute some of the abnormal PET findings to GD, which is a useful asset for quick recognition and clinical interpretation. |
| تواريخ الأحداث: | Date Created: 20080606 Date Completed: 20080819 Latest Revision: 20081121 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/MNM.0b013e3282fdc979 |
| PMID: | 18528184 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0143-3636 |
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| DOI: | 10.1097/MNM.0b013e3282fdc979 |