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18 F-fluoro-deoxy-glucose focal uptake in very small pulmonary nodules: fact or artifact? Case reports.
- Source :
- World Journal of Surgical Oncology; 2012, Vol. 10 Issue 1, p71-78, 8p, 5 Color Photographs
- Publication Year :
- 2012
-
Abstract
- Background: <superscript>18</superscript>F-fluoro-deoxy-glucose (<superscript>18</superscript>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 <superscript>18</superscript>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. Case presentation: We report five cases of oncologic patients showing focal lung <superscript>18</superscript>F-FDG uptake on PET-CT in nodules smaller than 1 cm. We also discuss the most common causes of <superscript>18</superscript>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 <superscript>18</superscript>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. Conclusion: In all five oncologic patients, <superscript>18</superscript>F-FDG was able to metabolically characterize as malignant those nodules smaller than 1 cm, underlining that: <superscript>18</superscript>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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14777819
- Volume :
- 10
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- World Journal of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 84380229
- Full Text :
- https://doi.org/10.1186/1477-7819-10-71