Detection of primary and recurrent lung cancer by means of F-18 fluorodeoxyglucose positron emission tomography (FDG PET)

Francis G. Duhaylongsod, Val Lowe, Edward F. Patz, Anna L. Vaughn, R. Edward Coleman, Walter G. Wolfe

Research output: Contribution to journalArticle

184 Citations (Scopus)

Abstract

Positron emission tomography (PET), with the glucose analog F-18 fluorodeoxyglucose (FDG), takes advantage of the enhanced glucose uptake observed in neoplastic cells. We examined whether the detection of preferential FDG uptake with PET permits differentiation between benign and malignant focal pulmonary lesions in patients with suspected primary or recurrent lung cancer. Between November 1991 and September 1993, 100 patients with indeterminate focal pulmonary abnormalities including 16 patients who had previous lung resections for cancer were prospectively studied. Tissue diagnosis was obtained by transbronchial or percutaneous biopsy (n=49) and open biopsy or resection (n=35). Three patients underwent extended observation (>2 years) alone. Excluded were 13 patients lacking firm pathologic diagnoses and less than 2-year follow-up. FDG activity in the lesion was expressed as a calculated standardized uptake ratio. Mean standardized uptake ratio (± standard deviation) was 6.6 (±3.1) in 59 patients with cancer versus 2.0 (±1.6) in 28 with benign disease (p=0.0001; unpaired t test, two-sided). With a standardized uptake ratio ≥2.5 used for detecting malignancy, sensitivity, specificity, and accuracy were 97% (57/59), 82% (23/28), and 92% (80/87), respectively. Notably, in patients evaluated for pulmonary abnormalities after lung resection for cancer, all chest recurrences were correctly identified. The exceptional sensitivity of FDG PET demonstrates that malignant pulmonary lesions preferentially accumulate FDG, which results in a standardized uptake ratio ≥2.5. PET may be useful for distinguishing recurrent tumor from postoperative, or postradiation, changes. If performed in all patients before open biopsy, PET increases the diagnostic yield by reducing the number of patients who have benign lesions at operation. Moreover, by lowering expenditures for hospitalization and other diagnostic procedures, FDG PET may significantly reduce health care costs.

Original languageEnglish (US)
Pages (from-to)130-140
Number of pages11
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume110
Issue number1
DOIs
StatePublished - 1995
Externally publishedYes

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Fluorodeoxyglucose F18
Positron-Emission Tomography
Lung Neoplasms
Lung
Biopsy
Glucose
Neoplasms
Health Expenditures
Health Care Costs
Hospitalization
Thorax
Observation
Recurrence
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Detection of primary and recurrent lung cancer by means of F-18 fluorodeoxyglucose positron emission tomography (FDG PET). / Duhaylongsod, Francis G.; Lowe, Val; Patz, Edward F.; Vaughn, Anna L.; Coleman, R. Edward; Wolfe, Walter G.

In: The Journal of Thoracic and Cardiovascular Surgery, Vol. 110, No. 1, 1995, p. 130-140.

Research output: Contribution to journalArticle

Duhaylongsod, Francis G. ; Lowe, Val ; Patz, Edward F. ; Vaughn, Anna L. ; Coleman, R. Edward ; Wolfe, Walter G. / Detection of primary and recurrent lung cancer by means of F-18 fluorodeoxyglucose positron emission tomography (FDG PET). In: The Journal of Thoracic and Cardiovascular Surgery. 1995 ; Vol. 110, No. 1. pp. 130-140.
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