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Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

 Arthur Cho  ;  Jin Hur  ;  Won Jun Kang  ;  Ho Jin Cho  ;  Jae-hoon Lee, Mijin Yun  ;  Jong Doo Lee 
 EUROPEAN RADIOLOGY, Vol.21(5) : 1077-1087, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Constriction, Pathologic ; Contrast Media/pharmacology ; False Negative Reactions ; Female ; Fluorodeoxyglucose F18/pharmacology* ; Humans ; Lung Neoplasms/diagnosis* ; Lung Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography/methods* ; Probability ; Pulmonary Atelectasis/diagnosis* ; Pulmonary Atelectasis/diagnostic imaging ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods*
FDG ; PET/CT ; Lung neoplasm ; Airway obstruction ; Pulmonary atelectasis
OBJECTIVE: To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis.

METHODS: This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung.

RESULTS: The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 ± 0.84; malignant SUV 11.8 ± 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%.

CONCLUSION: Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Jong Doo(이종두)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
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