¹⁸F-FDG distribution pattern improves the diagnostic accuracy of single pulmonary solid nodule

Area of Science:

• Nuclear Medicine
• Radiology
• Oncology

Background:

• Distinguishing benign from malignant pulmonary solid lesions is crucial for patient management.
• Heterogeneous uptake of 18F-FDG on PET/CT may indicate malignancy.
• Visual assessment offers a potentially simple method for lesion characterization.

Purpose of the Study:

• To evaluate the utility of visual assessment of 18F-FDG heterogeneous distribution in pulmonary lesions for differentiating benign from malignant.
• To compare visual and quantitative assessments of FDG uptake patterns.

Main Methods:

• Retrospective analysis of 200 pulmonary nodules/masses using 18F-FDG PET/CT.
• Visual and quantitative evaluation of 18F-FDG distribution heterogeneity.
• Calculation of sensitivity, specificity, PPV, NPV, and accuracy for differentiating lesion types.

Main Results:

• 171 lesions showed heterogeneity: 111 malignant and 60 benign.
• Malignant lesions predominantly showed proximal 18F-FDG uptake (93.69% visual, 96.40% quantitative).
• Benign lesions predominantly showed distal 18F-FDG uptake (90.00% visual, 86.67% quantitative).
• Combined PET/CT features achieved 98.25% accuracy.

Conclusions:

• Pulmonary lesions exhibit distinct patterns of 18F-FDG heterogeneity based on their nature (benign vs. malignant).
• Visual assessment of 18F-FDG distribution is a reliable and convenient method for distinguishing lung cancer.
• This technique aids in differentiating malignant lung lesions from infectious or inflammatory conditions.