Fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a review

Figures & data

Table 1. ¹⁸F-FDG-PET with and without CT in solid pulmonary nodule.

	Imaging	Threshold	N	Sensitivity	Specificity	Accuracy	PPV	NPV	Conclusions
Herder et al. (2004)	^18F-FDG-PET	SUVmax>2.5	36 (SPN <1 cm)	93.0	77.0	30.0	72.0	94.0	FDG PET imaging could be useful in differentiating benign from malignant SPNs ≤10 mm
Kim et al. (2007)	^18F-FDG-PET versus ^18F-FDG-PET/CT		42 (7–30 mm SPNs)	69.0 versus 97.0	85.0 versus 85.0				PET/CT demonstrates an excellent performance in classifying SPNs as benign or malignant
Kalaf et al. (2008)	^18F-FDG-PET	SUVmax>2.5	202 Group A (nodules <1 cm)	85.0	36.0	54.0
			Group B (nodules between 1.1 and 2.0 cm)	91.0	47.0	79.0			SUVmax cutoff of 2.5 is a useful tool in the evaluation of large pulmonary nodules (>1.0 cm), but it has no or minimal value in the evaluation of small pulmonary nodules
			Group C (nodules between 2.1 and 3.0 cm)	94.0	23.0	76.0
			Group D (nodules >3 cm)	100.0	17.0	82.0
Lan et al. (2008)	DTP-PET (45–55 min) (150–180 min)	SUVmax >2.5	96	91.5	67.6	83.2	81.8	98.3	Dual time point ^18F-FDG PET imaging is an important noninvasive method for the differentiation of malignant and nonmalignant lesions
				98.3	75.7	89.6	86.6	96.6
Li et al. (2011)	^18F-FDG-PET/CT		298	80.2	38.0	73.1	86.5	27.9	PET/CT can improve the diagnostic accuracy in the differentiation of an SPN.
Zang et al. (2013)	DTP-PET versus STP-PET		439	79.0 versus 77.0	73.0 versus 59.0				Dual time point ^18FDG-PET/CT appears to be more specific than single time point ^18FDG-PET/CT
Opoka et al. (2014)	^18F-FDG-PET/CT		82	95.0	88.0	91.5	88.4	94.8	PET-CT appeared to have high sensitivity (95%), but lower specificity (88%) for predicting the malignant character of solitary pulmonary lesions.
Demir et al. (2014)	DPT-^18F-FDG-PET/CT
	1 h	SUVmax 2.5 versus 2.75	48	94 versus 75	75 versus 80	83 versus 78			Dual-phase PET/CT may increase the diagnostic potential of PET/CT in the characterization of SPNs
	2 h			94 versus 100	77 versus 80	83 versus 88

Table 2. ¹⁸F-FDG-PET/CT versus CT in solid solitary pulmonary nodules.

	Imaging	Threshold	N	Sensitivity	Specificity	Accuracy	PPV	NPV	Conclusions
Yi et al. (2006)	HDCT versus PET-CT	>25 HU versus SUVmax>3.5	119 (79 malignant and 40 benign)	81/96	93/88	85/93			PET/CT is more sensitive and accurate than HDCT for malignant nodules characterization and may be performed as the first-line evaluation tool for SPN characterization
Kagna et al. (2009)	Visual PET-ldCT versus Semiquantitavite PET/ldCT versus ldCT		93 (high risk for LC)	94/77/97	80/83/48	80/81/66	66/73/53	95/86/96	Integrated PET scans is a valuable diagnostic tool for lung cancer screening in high risk patients
WalbomHandersat al (2012)	^18F-FDG PET/CT versus MDCT		168	97/93	47/53	81/82	89/89	79/63	Integrated PET should be not advocated as a first-line diagnostic exam in high risk patients, but MDCT should be considered
Dabrowska et al. (2015)	CECT versus 18-F-FDG PET/CT	19 HU versus SUVmax>2.5	71	100/77	37/92	0.58/0.9	32/83	100/89	CECT should be preferred in low risk patients, while PET should be recommended in high-risk ones due to high specificity and PPV levels.