Yumiko Onishi MD, Presenter: Nothing to Disclose

Yoshiharu Ohno MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Bayer AG Research grant, DAIICHI SANKYO Group Research grant, Eisai Co, Ltd Research grant, Mitsubishi Chemical Holdings Corporation Research grant, Terumo Corporation

Daisuke Takenaka MD, Abstract Co-Author: Nothing to Disclose

Hisanobu Koyama MD, Abstract Co-Author: Nothing to Disclose

Masanobu Koto RT, Abstract Co-Author: Nothing to Disclose

Takeshi Yoshikawa MD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV

Sumiaki Matsumoto MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation

Masahiko Fujii MD, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Mitsubishi Corporation Research grant, Bayer AG Research grant, Eisai Co, Ltd Research grant, DAIICHI SANKYO Group Research Consultant, Shionogi & Co, Ltd

To directly and prospectively compare capability for distinguishing malignant from benign nodules between profile curve assessment and standard uptake value (SUV) measurement on FDG-PET/CT in patients with solitary pulmonary nodule (SPN) .

Sixty-one patients (41males, 20females; mean age, 69years) with 61 SPNs underwent FDG-PET/CT with standard technique, microbacterial and pathological examinations from specimens obtained with transbronchial and CT-guided biopsies and/ or surgical resections, and more than 2-years follow up examinations. Final diagnosis of each patient was based on pathological examinations and/ or follow up examinations. On each SPN, maximum value of SUV (SUVmax) and maxim gradient from profile curve of SUV (SUVmax gradient) within each SPN were assessed by using ROI measurements. To compare two indexes between malignant and benign nodules, Student’s test were performed. Then, diagnostic capabilities of two indexes were evaluated by using ROC analyses, feasible threshold values of both indexes were determined. Finally, sensitivity, specificity and accuracy of each index were compared each other by means of McNemar’s test.

SUVmax and SUVmax gradient had significant difference between malignant and benign nodules (p<0.05). Area under the curve (Az) of SUVmax (Az=0.71) had no significant difference with that of SUVmax gradient (Az=0.78, p>0.05). Feaslble threshold values of SUVmax and SUV max gradient were determined as 2.9 and 1.9, respectively. Sensitivity (79.2 [42/53] %) and accuracy (77.0 [47/61] %) of SUVmax gradient were significantly higher than those of SUVmax (sensitivity: 64.2 [34/53] %, p<0.05; accuracy: 63.9 [39/61] %, p<0.05).

Profile curve assessment within ROI is more sensitive and accurate method than SUVmax measurement for distinguishing malignant SPNs from benign SPNs on FDG-PET/CT.

For differentiation of malignant SPNs from benign SPNs, profile curve assessment on FDG-PET/CT is more sensitive and accurate method than SUVmax measurement in routine clinical practice.

Onishi, Y, Ohno, Y, Takenaka, D, Koyama, H, Koto, M, Yoshikawa, T, Matsumoto, S, Fujii, M, Sugimura, K, Profile Curve Assessment versus Standard Uptake Value Measurement on FDG-PET/CT: Capability for Distinguishing Malignant Nodules from Benign Nodules in Patients with Solitary Pulmonary Nodule.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009523.html