Differentiating benign and malignant pulmonary lesions with FDG-PET

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Pulmonary lesions require accurate differentiation between benign and malignant types for effective patient management.
• Chest radiography findings often necessitate further investigation to confirm the nature of pulmonary lesions.

Purpose of the Study:

• To evaluate the efficacy of 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in distinguishing benign from malignant pulmonary lesions.
• To assess the diagnostic performance of FDG-PET, including sensitivity, specificity, and accuracy, in a cohort of patients with suspected pulmonary neoplasms.

Main Methods:

• Retrospective analysis of 55 patients with suspected primary pulmonary neoplasm undergoing FDG-PET scanning.
• Determination of Standard Uptake Value (SUV) for pulmonary lesions; SUV > 2.50 threshold used to classify lesions.
• Pathological diagnosis or clinical follow-up (≥4 months) used as the reference standard.

Main Results:

• FDG-PET correctly identified 34 true-positive and 15 true-negative lesions among 43 pathologically confirmed lesions.
• Mean SUV for benign lesions was 1.60±0.42, and for malignant lesions was 6.14±2.67.
• Overall sensitivity was 94%, specificity 71%, and accuracy 86%, with 6 false-positive and 1 false-negative findings.

Conclusions:

• FDG-PET demonstrates high sensitivity (94%) for detecting malignant pulmonary lesions.
• The specificity of FDG-PET can be reduced by false-positive results, often associated with inflammatory processes.
• FDG-PET is a valuable tool for diagnosing pulmonary lesions, but interpretation requires consideration of potential inflammatory mimics.