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¹⁸F-fluoro-deoxy-glucose focal uptake in very small pulmonary nodules: fact or artifact? Case reports.
- Source :
-
World journal of surgical oncology [World J Surg Oncol] 2012 Apr 28; Vol. 10, pp. 71. Date of Electronic Publication: 2012 Apr 28. - Publication Year :
- 2012
-
Abstract
- Background: 18F-fluoro-deoxy-glucose (18 F-FDG) positron emission tomography integrated/combined with computed tomography (PET-CT) provides the best diagnostic results in the metabolic characterization of undetermined solid pulmonary nodules. The diagnostic performance of 18 F-FDG is similar for nodules measuring at least 1 cm and for larger masses, but few data exist for nodules smaller than 1 cm.<br />Case Presentation: We report five cases of oncologic patients showing focal lung 18 F-FDG uptake on PET-CT in nodules smaller than 1 cm. We also discuss the most common causes of 18 F-FDG false-positive and false-negative results in the pulmonary parenchyma.In patient 1, contrast-enhanced CT performed 10 days before PET-CT did not show any abnormality in the site of uptake; in patient 2, high-resolution CT performed 1 month after PET showed a bronchiole filled with dense material interpreted as a mucoid impaction; in patient 3, contrast-enhanced CT performed 15 days before PET-CT did not identify any nodules; in patients 4 and 5, contrast-enhanced CT revealed a nodule smaller than 1 cm which could not be characterized. The 18 F-FDG uptake at follow-up confirmed the malignant nature of pulmonary nodules smaller than 1 cm which were undetectable, misinterpreted, not recognized or undetermined at contrast-enhanced CT.<br />Conclusion: In all five oncologic patients, 18 F-FDG was able to metabolically characterize as malignant those nodules smaller than 1 cm, underlining that: 18 F-FDG uptake is not only a function of tumor size but it is strongly related to the tumor biology; functional alterations may precede morphologic abnormalities. In the oncologic population, especially in higher-risk patients, PET can be performed even when the nodules are smaller than 1 cm, because it might give an earlier characterization and, sometimes, could guide in the identification of alterations missed on CT.
- Subjects :
- Aged
Aged, 80 and over
Carcinoma, Squamous Cell pathology
False Negative Reactions
False Positive Reactions
Fatal Outcome
Female
Humans
Lung Neoplasms pathology
Male
Multiple Pulmonary Nodules pathology
Solitary Pulmonary Nodule pathology
Tumor Burden
Carcinoma, Squamous Cell diagnostic imaging
Fluorodeoxyglucose F18
Lung Neoplasms diagnostic imaging
Multimodal Imaging
Multiple Pulmonary Nodules diagnostic imaging
Positron-Emission Tomography
Radiopharmaceuticals
Solitary Pulmonary Nodule diagnostic imaging
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1477-7819
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- World journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 22540935
- Full Text :
- https://doi.org/10.1186/1477-7819-10-71