The effect of a novel Bayesian penalised likelihood PET reconstruction algorithm on the assessment of malignancy risk in solitary pulmonary nodules according to the British Thoracic Society guidelines.
Eur J Radiol
; 117: 149-155, 2019 Aug.
Article
in En
| MEDLINE
| ID: mdl-31307640
ABSTRACT
PURPOSE:
British Thoracic Society (BTS) guidelines advocate using FDG PET-CT with the Herder model to estimate malignancy risk in solitary pulmonary nodules (SPNs). Qualitative and semi-quantitative assessment of SPN uptake is based upon analysis of Ordered Subset Expected Maximisation (OSEM) PET images. Our aim was to assess the effect of a Bayesian Penalised Likelihood (BPL) PET reconstruction on the assessment of SPN FDG uptake and estimation of malignancy risk (Herder score).METHODS:
Subjects with SPNs who underwent FDG PET-CT between 2014-2017, with histological confirmation of malignancy or histological/imaging follow-up confirmation of benignity were included. Two blinded readers independently classified SPN uptake on both OSEM and BPL (BTS score; 1 = none; 2 = ≤ mediastinal blood pool (MBP); 3 = >MBP but ≤ 2x liver; 4 = >2x liver), with resultant calculation of the Herder score (%) for both reconstructions.RESULTS:
97 subjects with 75 (77%) malignant SPNs were included. BPL increased the BTS score in 25 (26%) SPNs; 9 SPNs (7 malignant) increased from BTS score 2 to 3, 16 (13 malignant) from BTS score 3 to 4, with a mean Herder score increase of 18⯱â¯22%. The mean Herder score for all SPNs with BPL was higher than OSEM (73⯱â¯29 vs 68⯱â¯32%, pâ¯=â¯0.001). There was no difference in Herder model diagnostic performance between BPL and OSEM, with similar areas under the curve (0.84 vs 0.83, pâ¯=â¯0.39).CONCLUSION:
BPL increases the Herder score in 26% of SPNs compared to OSEM but does not alter the diagnostic performance of the Herder model.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Solitary Pulmonary Nodule
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Early Detection of Cancer
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Positron Emission Tomography Computed Tomography
/
Lung Neoplasms
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
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Risk_factors_studies
/
Screening_studies
Limits:
Aged
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Female
/
Humans
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Male
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Middle aged
Language:
En
Journal:
Eur J Radiol
Year:
2019
Document type:
Article