Vol 15, Supp. C (2012)
Published online: 2013-02-19

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PET-CT evaluation of solitary pulmonary nodules: with or without a radiologist?

Andrea d’Amico, Cesary Przeorek, Jolanta Siewińska, Kamil Gorczewski, Izabela Szopa, Joanna Sczasny, Maria Turska-d’Amico, Katarzyna Steinhof-Radwańska, Barbara Bobek-Billewicz, Jarosław Kużdżał


BACKGROUND: CT scan provides information about the anatomy
and morphology, may confirm whether the change is single
or has multifocal character and may suggest the probability of
malignancy. Due to increased metabolism, at PET examination
malignant tissues usually show a greater uptake of 18F-FDG than
benign changes and healthy tissue. In several cases, PET-CT
is described only by a specialist in nuclear medicine without
consulting a radiologist. The aim of this study is to evaluate the
accuracy of PET with assessment performed by a single nuclear
medicine specialist and multidisciplinary assessment by both
nuclear medicine and radiology specialists.

MATERIALS AND METHODS: PET-CT was performed in 58
consecutive patients referred from John Paul II Hospital in Cracow
because of radiologically diagnosed solitary pulmonary nodule (SPN) with diameter > 1 cm. An histopatological specimen
was obtained in 37 patients. In 17 cases PET-CT images
were evaluated by a single nuclear medicine specialist (group
A), while for the remaining 20 cases, the image evaluation was
performed shoulder-to-shoulder by a nuclear medicine specialist
and a radiologist (group B).

ANALYSIS OF DATA: Overall PET sensitivity, specificity, positive
and negative predictive value and accuracy were calculated on
the basis of anatomopathologic results. These data were also
calculated separately for groups A and B.

RESULTS: The histopatologic examination demonstrated the
non neoplastic character of 7/37 lesions. The sensitivity, specificity,
accuracy, positive and negative predictive values for group
A were 85.7%, 100%, 100%, 33.3% and 88% while for group B
were 92.8%, 83.3%, 92.8%, 83.3% and 90% respectively.

CONCLUSION: PET-CT is an accurate diagnostic method to assess
the nature of solitary pulmonary nodules. The consultation
with radiologist does not substantially affect the PET-CT diagnostic
accuracy, but can lead to a higher negative predictive value.

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