• Title/Summary/Keyword: Indeterminate solitary pulmonary nodule

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Role of PET in Evaluating Indeterminate Solitary Pulmonary Nodule with CT (CT상 악성여부가 불명확한 단일 폐결절에서의 양전자방출단층촬영술의 유용성)

  • Yoon, Seok-Boo;Choi, Joon-Young;Kim, Sun-Jung;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Sang-Eun;Kwon, O-Jung;Lee, Kyung-Soo;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.83-89
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    • 1997
  • About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We peformed FDG-PET studies in patients who had radiologically indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC), Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch-ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.

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Prevalence of Benign Pulmonary Lesions Excised for Suspicion of Malignancy: Could It Reflect a Quality Management Index of Indeterminate Lung Lesions?

  • Carillo, Gerardo Andres Obeso;Vazquez, Jose Eduardo Rivo;Villar, Alberto Fernandez
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.458-464
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    • 2014
  • Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.