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Outcome of PET-Negative Solid Pulmonary Nodules: A Retrospective Study
Jesse Chen1, Varun Mehta2, Varun Chowdhary3
1Staten Island University Hospital, Department of Radiology, Staten Island, NY.
Academic Radiology
|April 19, 2020
Summary
Malignancy developed in 18.2% of PET-negative solitary pulmonary nodules (SPN) on follow-up, indicating a need for extended monitoring beyond current guidelines for these potentially active lesions.
Area of Science:
- Pulmonology
- Oncology
- Radiology
Background:
- Solid solitary pulmonary nodules (SPN) with negative positron emission tomography/computed tomography (PET/CT) scans are often presumed inactive.
- However, malignancy has been observed in some patients with initially PET-negative SPNs upon follow-up.
Purpose of the Study:
- To investigate the natural history and malignant potential of PET-negative solid solitary pulmonary nodules.
- To determine the rate of subsequent malignancy development from these lesions.
Main Methods:
- Retrospective analysis of patients with incidentally discovered solid SPNs and negative follow-up PET/CT scans between 2005 and 2015.
- Chart review to identify subsequent malignancies arising from the index nodules.
Main Results:
- Out of 62 patients with PET-negative SPNs, 44 had follow-up of the index lesion.
- Eight subsequent malignancies were identified, with 7 being pathology-proven.
- The mean time to diagnosis for these malignancies was 37.6 months.
Conclusions:
- 18.2% of initially PET-negative SPNs developed subsequent malignancy, with a mean time to diagnosis of 37.6 months.
- This suggests that follow-up for these nodules should extend beyond the currently recommended 2 years.
- A negative PET/CT scan should not replace tissue diagnosis for non-FDG avid SPNs.
Keywords:
SPN
