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(18)F-FDG PET versus (18)F-FDG PET/CT for adrenal gland lesion characterization: a comparison of diagnostic efficacy in lung cancer patients.

Sung YM, Lee KS, Kim BT, Choi JY, Chung MJ, Shim YM, Yi CA, Kim TS - Korean J Radiol (2008 Jan-Feb)

Bottom Line: PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake.The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test.Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Gu, Seoul, Korea.

ABSTRACT

Objective: The aim of this study was to assess the diagnostic efficacy of integrated PET/CT using fluorodeoxyglucose (FDG) for the differentiation of benign and metastatic adrenal gland lesions in patients with lung cancer and to compare the diagnostic efficacy with the use of PET alone.

Materials and methods: Sixty-one adrenal lesions (size range, 5-104 mm; mean size, 16 mm) were evaluated retrospectively in 42 lung cancer patients. Both PET images alone and integrated PET/CT images were assessed, respectively, at two-month intervals. PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake. Final diagnoses of adrenal gland lesions were made at clinical follow-up (n = 52) or by a biopsy (n = 9) when available. The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test.

Results: Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign. For the depiction of adrenal gland metastasis, the sensitivity, specificity, and accuracy of PET were 74%, 73%, and 74%, respectively, whereas those of integrated PET/CT were 80%, 89%, and 84%, respectively (p values; 0.5, 0.125, and 0.031, respectively).

Conclusion: The use of integrated PET/CT is more accurate than the use of PET alone for differentiating benign and metastatic adrenal gland lesions in lung cancer patients.

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Related in: MedlinePlus

A false-positive interpretation by the use of both PET and PET/CT in a 33-year-old woman with an adrenal adenoma that was confirmed by surgical excision. The patient also had an adenocarcinoma in the left lower lobe of the lung.A. PET demonstrates increased uptake (arrow) in the left adrenal gland lesion with a maximum standardized uptake value of 4.6.B. An unenhanced CT scan shows a 14 mm sized nodule (arrow) in the left adrenal gland.C. Integrated PET/CT shows high uptake (arrow) in the nodule of the left adrenal gland.
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Figure 2: A false-positive interpretation by the use of both PET and PET/CT in a 33-year-old woman with an adrenal adenoma that was confirmed by surgical excision. The patient also had an adenocarcinoma in the left lower lobe of the lung.A. PET demonstrates increased uptake (arrow) in the left adrenal gland lesion with a maximum standardized uptake value of 4.6.B. An unenhanced CT scan shows a 14 mm sized nodule (arrow) in the left adrenal gland.C. Integrated PET/CT shows high uptake (arrow) in the nodule of the left adrenal gland.

Mentions: For the integrated PET/CT images, three false positive interpretations were made, and these stemmed from two adrenal adenomas (Fig. 2) and one endothelial cyst (Fig. 3) in the adrenal glands. For the seven false negative interpretations made, the mean size and mean maximum SUV value were 7 mm (range, 5-11 mm) and 1.0 (range, 0-2.4), respectively (Table 1).


(18)F-FDG PET versus (18)F-FDG PET/CT for adrenal gland lesion characterization: a comparison of diagnostic efficacy in lung cancer patients.

Sung YM, Lee KS, Kim BT, Choi JY, Chung MJ, Shim YM, Yi CA, Kim TS - Korean J Radiol (2008 Jan-Feb)

A false-positive interpretation by the use of both PET and PET/CT in a 33-year-old woman with an adrenal adenoma that was confirmed by surgical excision. The patient also had an adenocarcinoma in the left lower lobe of the lung.A. PET demonstrates increased uptake (arrow) in the left adrenal gland lesion with a maximum standardized uptake value of 4.6.B. An unenhanced CT scan shows a 14 mm sized nodule (arrow) in the left adrenal gland.C. Integrated PET/CT shows high uptake (arrow) in the nodule of the left adrenal gland.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627169&req=5

Figure 2: A false-positive interpretation by the use of both PET and PET/CT in a 33-year-old woman with an adrenal adenoma that was confirmed by surgical excision. The patient also had an adenocarcinoma in the left lower lobe of the lung.A. PET demonstrates increased uptake (arrow) in the left adrenal gland lesion with a maximum standardized uptake value of 4.6.B. An unenhanced CT scan shows a 14 mm sized nodule (arrow) in the left adrenal gland.C. Integrated PET/CT shows high uptake (arrow) in the nodule of the left adrenal gland.
Mentions: For the integrated PET/CT images, three false positive interpretations were made, and these stemmed from two adrenal adenomas (Fig. 2) and one endothelial cyst (Fig. 3) in the adrenal glands. For the seven false negative interpretations made, the mean size and mean maximum SUV value were 7 mm (range, 5-11 mm) and 1.0 (range, 0-2.4), respectively (Table 1).

Bottom Line: PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake.The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test.Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Gu, Seoul, Korea.

ABSTRACT

Objective: The aim of this study was to assess the diagnostic efficacy of integrated PET/CT using fluorodeoxyglucose (FDG) for the differentiation of benign and metastatic adrenal gland lesions in patients with lung cancer and to compare the diagnostic efficacy with the use of PET alone.

Materials and methods: Sixty-one adrenal lesions (size range, 5-104 mm; mean size, 16 mm) were evaluated retrospectively in 42 lung cancer patients. Both PET images alone and integrated PET/CT images were assessed, respectively, at two-month intervals. PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake. Final diagnoses of adrenal gland lesions were made at clinical follow-up (n = 52) or by a biopsy (n = 9) when available. The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test.

Results: Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign. For the depiction of adrenal gland metastasis, the sensitivity, specificity, and accuracy of PET were 74%, 73%, and 74%, respectively, whereas those of integrated PET/CT were 80%, 89%, and 84%, respectively (p values; 0.5, 0.125, and 0.031, respectively).

Conclusion: The use of integrated PET/CT is more accurate than the use of PET alone for differentiating benign and metastatic adrenal gland lesions in lung cancer patients.

Show MeSH
Related in: MedlinePlus