Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

The Role of Integrated PET/CT and PET Imaging In Diagnosing Solitary Pulmonary Nodule as Malignant Nodule*

  • Dr Tai Kian Wong, Department of Nuclear Medicine & Centre for P.E.T., Austin Health, Australia
  • Dr Salvatore Berlangieri, Department of Nuclear Medicine & Centre for P.E.T., Austin Health, Australia
  • Dr HB Toh, Department of Nuclear Medicine & Centre for P.E.T., Austin Health, Australia
  • Prof Christopher Rowe, Department of Nuclear Medicine & Centre for P.E.T., Austin Health, Australia
  • Prof Andrew Scott, Centre for P.E.T., Austin Health, Australia

    • Objective: The aim of this study was to evaluate integrated 18F-FDG PET/CT (PET/CT) in differentiating malignant from benign pulmonary nodules (SPN) and to determine the incremental value of the non-contrast, low-dose CT component of the PET/CT study over PET alone.

    Method: In this retrospective study, 37 patients with true SPN, less than 3 cm in diameter, with a final diagnosis based on either histology or CT follow up over 2 year period or disappearance of SPN over 6 month were included for analysis. Patients underwent PET/CT following our standard preparation on a Philips Gemini PET/CT scanner. Two readers reviewed the scans blinded to clinical and radiologic information. PET was interpreted alone and then, in combination with the low-dose CT. Discordant readings between readers where resolved by a consensus reading. Area under the reader operator curve (ROC) analysis was used to determine the best cut-off for performance characteristics of both modalities.

    Results: The prevalence of malignancy in our cohort was 62%. The sensitivity, specificity, accuracy of PET alone in detecting malignant nodules was 87%, 64% and 78%, respectively, and when combined with CT, 95%, 50%, and 78%. Integrated PET/CT show a trend toward higher sensitivity but did not reach statistical significance due to the small sample size.

    Conclusion: PET alone and integrated PET/CT both accurately differentiate benign from malignant pulmonary nodules. PET/CT shows a tendency to be more sensitive than PET alone, however, further studies with larger series are required to confirm this finding.

    Conference Organiser - ICMS Pty Ltd