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Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer.
Sugawara, Haruto; Kikkawa, Nao; Ito, Kimiteru; Watanabe, Hirokazu; Kaku, Sawako; Akai, Hiroyuki; Abe, Osamu; Watanabe, Shun-Ichi; Yatabe, Yasushi; Kusumoto, Masahiko.
Affiliation
  • Sugawara H; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Kikkawa N; Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
  • Ito K; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Watanabe H; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Kaku S; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Akai H; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Abe O; Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
  • Watanabe SI; Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan.
  • Yatabe Y; Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan.
  • Kusumoto M; Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Br J Radiol ; 97(1154): 462-468, 2024 Feb 02.
Article in En | MEDLINE | ID: mdl-38308036
ABSTRACT

OBJECTIVES:

To determine the image characteristics associated with low 18F-FDG (18F-fluorodeoxyglucose) avidity among 8-15 mm solid lung cancer.

METHODS:

Patients satisfying the following criteria were included underwent surgery between January 2014 and December 2019 for lung cancer, presented 8-15 mm nodule without measurable ground glass component on preoperative CT, and underwent 18F-FDG PET before resection. Image characteristics, including air bronchogram, concave shape, pleural attachment, and background emphysema, were evaluated by two board-certified radiologists. The Mann-Whitney U test was used to compare maximum standardized uptake (SUVmax) values from 18F-FDG PET images.

RESULTS:

The analysis included 235 patients. The SUVmax values of lesions with air bronchogram and concave shape were significantly lower than the SUVmax values of lesions without these features (median 1.55 vs 2.56 and 1.66 vs 2.45, both P < .001), whereas lesions arising from emphysematous lungs had significantly higher SUVmax values than lesions arising from non-emphysematous lungs (2.90 vs 1.69, P < .001). No significant differences were detected between lesions attached and not attached to pleura. The interobserver agreement was almost perfect for air bronchograms and background emphysema (κ = 0.882 and 0.927, respectively), and 89.7% of lesions with air bronchograms and arising from non-emphysematous lungs showed SUVmax values below 2.5.

CONCLUSIONS:

Among 8-15 mm solid lung cancer, the presence of air bronchograms and concave shape and the absence of background emphysema were associated with low 18F-FDG accumulation. ADVANCES IN KNOWLEDGE 18F-FDG PET can be misleading in differentiating certain type of small solid lung cancer.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Emphysema / Lung Neoplasms Type of study: Diagnostic_studies Limits: Humans Language: En Journal: Br J Radiol Year: 2024 Document type: Article Affiliation country: Japan Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Emphysema / Lung Neoplasms Type of study: Diagnostic_studies Limits: Humans Language: En Journal: Br J Radiol Year: 2024 Document type: Article Affiliation country: Japan Country of publication: United kingdom