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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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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. |
format | Online Article Text |
id | pubmed-4999143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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