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FDG PET assessment of SPN in WA: preliminary findings

conference contribution
posted on 2023-05-24, 17:51 authored by Leong, J, Lenzo, N, Kerryn Butler-HendersonKerryn Butler-Henderson

Purpose: Positron emission tomography using FDG is rebated for the assessment of solitary pulmonary nodule (SPN) in a number of countries including Australia. The nature of the cause of SPN however varies between countries and often within countries. The accuracy of this modality has not been previously assessed in Western Australia. The purpose of this study was to investigate patients referred for assessment of SPN at the WA PET/Cyclotron Service.

Methods: A retrospective analysis of all patients referred for assessment of SPN to the WA PET/Cyclotron Service from November 2002 to July 2005 was performed. These included T1NOMO and TxNOMO studies which were felt by the referring doctor to be SPN. The CT, PET and clinicopathologic outcomes were recorded.The sensitivity and specificity of PET in SPN in our cohort was calculated.

Results: 150 PET studies were referred as SPN over the time period analysed. On review of data, particularly CT data, 71 were excluded as they did not fulfil the defined criteria for SPN. Of the remaining 79, forty (40) were excluded due to incomplete follow-up or incomplete case notes to accurately confirm SPN or subsequent diagnosis. Of the 39 studies with complete data the PET scan confirmed the clinicopathological findings in 33 cases (sensitivity 85%). Of the 33 cases, nine (9) cases showed low FDG uptake and were shown to be benign and 24 cases showed high FDG uptake and were shown to be malignant. Of the six cases that had PET and clinicopathologic mismatch two (2) cases proved to be bronchoalveolar carcinoma.

Conclusion: Our preliminary data reveals that FDG PET in WA appears to be useful in the evaluation of SPN. Its sensitivity is however somewhat less than reported elsewhere in Australia and around the world. If the pre-test probability of malignancy is high then further investigation should be considered even if FDG avidity is low. Of concern is also the high number of cases which appear to be misclassified at initial referral for assessment of SPN.


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Royal Australasian College of Physicians Internal Medicine Journal










Wiley-Blackwell Publishing Asia

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36th ASM of the ANZSNM

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Clinical health not elsewhere classified

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