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

  • Nuclear Medicine
  • Published:
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Abstract

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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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, Yonsei University Health System, 134 Shinchon-dong, Seodaemoon-ku, Seoul, South Korea, 120-752

    Arthur Cho, Won Jun Kang, Ho Jin Cho, Jae-hoon Lee, Mijin Yun & Jong Doo Lee

  2. Department of Radiology, Yonsei University Health System, Seoul, South Korea

    Jin Hur

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  1. Arthur Cho
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  2. Jin Hur
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  3. Won Jun Kang
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  4. Ho Jin Cho
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  7. Jong Doo Lee
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Correspondence to Jong Doo Lee.

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Cho, A., Hur, J., Kang, W.J. et al. Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction. Eur Radiol 21, 1077–1087 (2011). https://doi.org/10.1007/s00330-010-2006-1

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  • DOI: https://doi.org/10.1007/s00330-010-2006-1

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