| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3982132 | Clinical Radiology | 2014 | 6 Pages |
•The role of PET/CT in the detection of pulmonary malignancy has been overestimated.•There are some independent risk factors for negative PET/CT findings of NSCLC.•Our study can promote the reasonable use of PET/CT in partial.
AimTo investigate the accuracy and efficacy of combined 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) in the diagnosis of pulmonary nodules.Material and methodsThe present retrospective study included 298 patients with clinically suspected pulmonary malignancy who underwent preoperative PET/CT. The results of PET/CT were compared with the histopathological findings after thoracotomy or thoracoscopic surgery.ResultsOf 298 patients, pulmonary malignancy was histopathologically diagnosed in 248 and benign lesions in 50 patients. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT in detecting malignant lesions were 80.2%, 38%, 86.5%, 27.9%, and 73.1%, respectively. The specificity and NPV were very low, and the area under curve (AUC) in the receiver operating characteristic (ROC) curve analysis was 0.694. For 219 patients with non-small cell lung cancer (NSCLC), falsely negative results occurred in 43 patients. The multivariate risk-factor analysis identified high differentiation (p < 0.001), peripheral lung cancer (p = 0.016), non-pleural invasion (p = 0.001), tumour size ≤3 cm (p = 0.026), adenocarcinoma (p = 0.062) and non-smoker (p = 0.066) as risk factors for false negatives..ConclusionThe study suggests that the role of PET/CT in the detection of pulmonary malignancy has been overestimated in the past. It warrants attention that high differentiation, peripheral lung cancer, non-pleural invasion, tumour size ≤3 cm, adenocarcinoma, and non-smoker were independent risk factors for negative PET/CT findings of NSCLC..
