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The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

OBJECTIVE: The aim of our study was to evaluate the role of (18)F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. METHODS: A total of 176 patients with pleural effusion who underwent (18)F-FDG PET/CT examination to differentiate malignancy from benignancy wer...

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Autores principales: Sun, Yajuan, Yu, Hongjuan, Ma, Jingquan, Lu, Peiou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999143/
https://www.ncbi.nlm.nih.gov/pubmed/27560933
http://dx.doi.org/10.1371/journal.pone.0161764
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author Sun, Yajuan
Yu, Hongjuan
Ma, Jingquan
Lu, Peiou
author_facet Sun, Yajuan
Yu, Hongjuan
Ma, Jingquan
Lu, Peiou
author_sort Sun, Yajuan
collection PubMed
description OBJECTIVE: The aim of our study was to evaluate the role of (18)F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. METHODS: A total of 176 patients with pleural effusion who underwent (18)F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural (18)F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of (18)F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural (18)F-FDG uptake on PET imaging. RESULTS: One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of (18)F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, (18)F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with (18)F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and (18)F-FDG PET/CT integrated imaging were higher than that of (18)F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with (18)F-FDG PET/CT integrated imaging compared with (18)F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively). CONCLUSION: (18)F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than (18)F-FDG PET imaging and CT imaging alone. For image interpretation of (18)F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively.
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spelling pubmed-49991432016-09-12 The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion Sun, Yajuan Yu, Hongjuan Ma, Jingquan Lu, Peiou PLoS One Research Article OBJECTIVE: The aim of our study was to evaluate the role of (18)F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. METHODS: A total of 176 patients with pleural effusion who underwent (18)F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural (18)F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of (18)F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural (18)F-FDG uptake on PET imaging. RESULTS: One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of (18)F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, (18)F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with (18)F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, (18)F-FDG PET imaging and (18)F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and (18)F-FDG PET/CT integrated imaging were higher than that of (18)F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with (18)F-FDG PET/CT integrated imaging compared with (18)F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively). CONCLUSION: (18)F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than (18)F-FDG PET imaging and CT imaging alone. For image interpretation of (18)F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively. Public Library of Science 2016-08-25 /pmc/articles/PMC4999143/ /pubmed/27560933 http://dx.doi.org/10.1371/journal.pone.0161764 Text en © 2016 Sun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sun, Yajuan
Yu, Hongjuan
Ma, Jingquan
Lu, Peiou
The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title_full The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title_fullStr The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title_full_unstemmed The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title_short The Role of (18)F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion
title_sort role of (18)f-fdg pet/ct integrated imaging in distinguishing malignant from benign pleural effusion
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999143/
https://www.ncbi.nlm.nih.gov/pubmed/27560933
http://dx.doi.org/10.1371/journal.pone.0161764
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