FDG-PET imaging and the diagnosis of non-small cell lung cancer in a region of high histoplasmosis prevalence.

Abstract

STUDY OBJECTIVE:

Determine the sensitivity and specificity of [F-18]-fluorine-2-deoxy-D-glucose positron emission tomography (FDG-PET) in differentiating non-small cell lung cancer (NSCLC) from benign solitary pulmonary nodules (SPNs) in a region with a high endemic rate of histoplamosis.

DESIGN:

Prospective, clinical study.

SETTING:

University, tertiary referral hospital in the upper Mississippi River valley.

PATIENTS:

Ninety patients with SPNs.

INTERVENTIONS:

Independent interpretation of FDG-PET imaging, computed tomography and pathologic evaluation of the SPNs.

MEASUREMENTS AND RESULTS:

To detect malignant SPNs, FDG-PET imaging had a sensitivity of 93%, a specificity of 40%, a positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 55%.

CONCLUSIONS:

In a region with a high prevalence of pulmonary fungal infection, FDG-PET is sensitive but has a low specificity and NPV for identifying NSCLC. In our study cohort, FDG-PET does not appear to reduce the need for SPN biopsies.

• Authors: Donita R Croft, John Trapp, Kemp Kernstine, Peter Kirchner, Brian Mullan, Jeffery Galvin, Michael W Peterson, Thomas Gross, Geoffrey McLennan, Jeffrey A Kern
• Journal: Lung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 36 Issue 3 Pg. 297-301 (Jun 2002) ISSN: 0169-5002 [Print] Ireland
• PMID: 12009241 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung (diagnostic imaging)
• Diagnosis, Differential
• Female
• Fluorodeoxyglucose F18
• Histoplasmosis (diagnostic imaging, epidemiology)
• Humans
• Iowa (epidemiology)
• Lung Neoplasms (diagnostic imaging)
• Male
• Middle Aged
• Predictive Value of Tests
• Prevalence
• Prospective Studies
• Radiopharmaceuticals
• Sensitivity and Specificity
• Tomography, Emission-Computed
• Tomography, X-Ray Computed