Incremental value of integrated FDG-PET/CT in evaluating indeterminate solitary pulmonary nodule for malignancy

Chih Yung Chang, Ching Tzao, Shih Chun Lee, Cheng Yi Cheng, Chang Hsien Liu, Wen Sheng Huang, Chih Hung Ku, Jong Kang Lee, Ching Yee Oliver Wong

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


Objectives: The objective of this study was to evaluate the increased diagnostic benefit of integrated positron emission tomography/computed tomography (PET/CT) interpretation in evaluating solitary pulmonary nodules for malignancy. Methods: One hundred seventeen patients (67 men and 50 women; mean age ± SD, 61.7± 13.6 years, range, 31-86 years) with indeterminate solitary pulmonary nodules and no previous history of malignancy were analyzed. PET/CT was performed with an integrated PET/CT scanner (Siemens Biograph BGO duo) 1 h after an intravenous injection of 370 MBq (10 mCi) 18F- fluorodeoxyglucose. Patients fasted for 6 h before imaging. PET was interpreted alone or combined with CT and was graded according to a five-point scale. A malignant diagnosis was based on histological findings or a clinical and radiological follow-up after at least 24 months. The diagnostic performances of PET alone and integrated PET/CT interpretation were evaluated using discriminant analysis. Results: PET alone correctly classified 85% of nodules and integrated PET/CT interpretation increased the correct classification to 89%, with similar sensitivity and specificity of 88% and 89%, respectively. False-positive PET results mainly resulted from granulomatous disorders. Four (50%) of the eight cases deemed indeterminate on PET alone were resolved with combined PET/CT interpretation. Conclusions: Although the benefit attributable to the CT component was limited when integrated PET/CT was used, PET and CT acted synergistically to significantly increase the diagnostic veracity for PET-indeterminate nodules.

Original languageEnglish
Pages (from-to)204-209
Number of pages6
JournalMolecular Imaging and Biology
Issue number2
Publication statusPublished - Apr 2010
Externally publishedYes


  • FDG
  • Lung cancer
  • PET/CT
  • Solitary pulmonary nodule

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Radiology Nuclear Medicine and imaging


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