Characterization of chest masses by FDG positron emission tomography

Karl Hubner, E. Buonocore, S. K. Singh, H. R. Gould, D. W. Cotten

Research output: Contribution to journalArticle

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Abstract

Radiographic imaging techniques have proved to be of limited value in characterizing chest masses. Likewise, scintigraphic techniques with tumor- seeking single photon emitting agents have shown marginal practical benefit. In contrast, high resolution PET with [F-18]-2-fluoro-2-D-deoxyglucose (FDG) offers a unique opportunity to distinguish benign from malignant processes by determining metabolic characteristics. PET scan results, including graphical analysis of tumor transfer constants (Patlak plot) in 21 patients with primary lung cancer, were compared to clinical outcome (histologic proof or clinical follow-up of longer than 1 year) in 54 patients who had chest masses identified by CT and/or plain film. The patients were categorized into three groups. The first group (N = 23) had primary, unknown, lung masses. DIfferentiation of benign from malignant tumors by PET had a sensitivity of 100% and a specificity of 67%. The second group (N = 13) had proven lung carcinoma or lymphoma and post-therapy PET scanning for recurrent tumor. In this setting, PET had a sensitivity of 83% and a specificity of 80%. The third group (N = 18) had extrathoracic malignancies and suspected pulmonary metastases. Metastatic lesions were identified with a sensitivity of 87% and specificity of 83%. Glucose uptake by normal tissue is variable and inflammatory/infectious processes can have high FDG uptake and overlap with the glucose uptake of malignant tissue. FDG PET is useful in characterizing chest tumors based on the level of their metabolic activity. Malignant tissue has a high glucose uptake. Elevated FDG uptake by an active inflammatory process may produce overlapping results. Despite this shortcoming, PET can help to separate benign from most malignant lung lesions, to confirm lung metastases, and to monitor the therapy of chest neoplasms.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalClinical Nuclear Medicine
Volume20
Issue number4
DOIs
StatePublished - Jan 1 1995

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Positron-Emission Tomography
Thorax
Lung
Neoplasms
Glucose
Neoplasm Metastasis
Fluorodeoxyglucose F18
Motion Pictures
Photons
Lymphoma
Lung Neoplasms
Carcinoma
Sensitivity and Specificity
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Characterization of chest masses by FDG positron emission tomography. / Hubner, Karl; Buonocore, E.; Singh, S. K.; Gould, H. R.; Cotten, D. W.

In: Clinical Nuclear Medicine, Vol. 20, No. 4, 01.01.1995, p. 293-298.

Research output: Contribution to journalArticle

Hubner, Karl ; Buonocore, E. ; Singh, S. K. ; Gould, H. R. ; Cotten, D. W. / Characterization of chest masses by FDG positron emission tomography. In: Clinical Nuclear Medicine. 1995 ; Vol. 20, No. 4. pp. 293-298.
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