Use of 18-Fluorodeoxyglucose-Positron Emission Tomography in Differentiating between Malignant and Benign Pulmonary Diseases in a Region with a High Incidence Rate of Tuberculosis

於結核病盛行地區利用18-FDG PET分辨良性與惡性胸腔病變之應用

林鎮均(Chen-Chun Lin) ； 高尚志(Shang-Jyh Kao) ； 林嘉謨(Chia-Mo Lin)

《胸腔醫學》 21卷2期 (2006/04) Pp. 141-148

https://doi.org/10.29806/TM.200604.0002

摘要

Study objective: To evaluate the accuracy of 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the diagnosis of pulmonary diseases in a region with a high incidence rate of tuberculosis.
Materials and Methods: Data on patients with newly found intrathoracic lesions on FDG-PET examination were screened from our PET scan database. A total of 81 patients with a definitive diagnosis were included in this retrospective study.
Results: Seventy of 81 patients had histopathological and/or microbiological proof of the final diagnosis. Thirty-six patients proved to have malignancy, and 45 had other benign diseases. The mean maximal standardized uptake value (SUV) was significantly higher in the group with malignant disease compared with the group with benign disease (p＜0.05). However, there was no statistical difference between the mean maximal SUVs of benign granulomatous disease and those of malignant disease (p＞0.05). If a maximal SUV＞2.5 was used as the cut-off value for malignant disease, the sensitivity was 97%, the specificity was 27%, the positive predictive value was 51%, and the negative predictive value was 92%.
Conclusion: In geographic regions with a high incidence rate of granulomatous diseases, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.
Study objective: To evaluate the accuracy of 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the diagnosis of pulmonary diseases in a region with a high incidence rate of tuberculosis.
Materials and Methods: Data on patients with newly found intrathoracic lesions on FDG-PET examination were screened from our PET scan database. A total of 81 patients with a definitive diagnosis were included in this retrospective study.
Results: Seventy of 81 patients had histopathological and/or microbiological proof of the final diagnosis. Thirty-six patients proved to have malignancy, and 45 had other benign diseases. The mean maximal standardized uptake value (SUV) was significantly higher in the group with malignant disease compared with the group with benign disease (p＜0.05). However, there was no statistical difference between the mean maximal SUVs of benign granulomatous disease and those of malignant disease (p＞0.05). If a maximal SUV＞2.5 was used as the cut-off value for malignant disease, the sensitivity was 97%, the specificity was 27%, the positive predictive value was 51%, and the negative predictive value was 92%.
Conclusion: In geographic regions with a high incidence rate of granulomatous diseases, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.

關鍵字

縱膈腔副甲狀腺腺瘤 ； 高血鈣 ； 甲狀腺賀爾蒙

並列摘要

Study objective: To evaluate the accuracy of 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the diagnosis of pulmonary diseases in a region with a high incidence rate of tuberculosis.
Materials and Methods: Data on patients with newly found intrathoracic lesions on FDG-PET examination were screened from our PET scan database. A total of 81 patients with a definitive diagnosis were included in this retrospective study.
Results: Seventy of 81 patients had histopathological and/or microbiological proof of the final diagnosis. Thirty-six patients proved to have malignancy, and 45 had other benign diseases. The mean maximal standardized uptake value (SUV) was significantly higher in the group with malignant disease compared with the group with benign disease (p＜0.05). However, there was no statistical difference between the mean maximal SUVs of benign granulomatous disease and those of malignant disease (p＞0.05). If a maximal SUV＞2.5 was used as the cut-off value for malignant disease, the sensitivity was 97%, the specificity was 27%, the positive predictive value was 51%, and the negative predictive value was 92%.
Conclusion: In geographic regions with a high incidence rate of granulomatous diseases, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.
Study objective: To evaluate the accuracy of 18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the diagnosis of pulmonary diseases in a region with a high incidence rate of tuberculosis.
Materials and Methods: Data on patients with newly found intrathoracic lesions on FDG-PET examination were screened from our PET scan database. A total of 81 patients with a definitive diagnosis were included in this retrospective study.
Results: Seventy of 81 patients had histopathological and/or microbiological proof of the final diagnosis. Thirty-six patients proved to have malignancy, and 45 had other benign diseases. The mean maximal standardized uptake value (SUV) was significantly higher in the group with malignant disease compared with the group with benign disease (p＜0.05). However, there was no statistical difference between the mean maximal SUVs of benign granulomatous disease and those of malignant disease (p＞0.05). If a maximal SUV＞2.5 was used as the cut-off value for malignant disease, the sensitivity was 97%, the specificity was 27%, the positive predictive value was 51%, and the negative predictive value was 92%.
Conclusion: In geographic regions with a high incidence rate of granulomatous diseases, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.

並列關鍵字

18-fluorodeoxyglucose-positron emission tomography ； lung cancer ； granulomatous disease