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Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country

OBJECTIVE: To determine the diagnostic efficacy of (18)F‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB. METHODS: Patients with SPN who underwent (18)F‐FDG PET/CT imaging were retrospecti...

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Autores principales: Niyonkuru, Alexandre, Chen, Xiaomin, Bakari, Khamis Hassan, Wimalarathne, Dilani Neranjana, Bouhari, Altine, Arnous, Maher Mohamad Rajab, Lan, Xiaoli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997090/
https://www.ncbi.nlm.nih.gov/pubmed/31837121
http://dx.doi.org/10.1002/cam4.2770
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author Niyonkuru, Alexandre
Chen, Xiaomin
Bakari, Khamis Hassan
Wimalarathne, Dilani Neranjana
Bouhari, Altine
Arnous, Maher Mohamad Rajab
Lan, Xiaoli
author_facet Niyonkuru, Alexandre
Chen, Xiaomin
Bakari, Khamis Hassan
Wimalarathne, Dilani Neranjana
Bouhari, Altine
Arnous, Maher Mohamad Rajab
Lan, Xiaoli
author_sort Niyonkuru, Alexandre
collection PubMed
description OBJECTIVE: To determine the diagnostic efficacy of (18)F‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB. METHODS: Patients with SPN who underwent (18)F‐FDG PET/CT imaging were retrospectively included in the study. The final diagnosis was established by histopathology. A linear regression equation was fitted to a scatter plot of size and SUVmax of lung cancer and PTB. ROC was used to determine the optimal cutoff values and diagnostic accuracy of (18)F‐FDG PET/CT in PTB and lung cancer. RESULTS: About 514 patients were included with the mean age of 57.5 ± 10.6 years. Four hundred and seventy‐five cases were diagnosed as lung cancer, and 39 cases were PTB by histopathology. (18)F‐FDG PET/CT had sensitivity, specificity, and diagnostic accuracy of 96.0%, 48.7%, and 92.0%, respectively. Utilization of SUVmax ≥2.5 in SPN resulted in 2 and 11 false positives cases of lung cancer and PTB, respectively, whereas SUVmax <2.5 resulted in 18 and 10 false‐positive cases of lung cancer and PTB, respectively. The SUVmax and the size of short‐axis in the lung cancer group were statistically higher than those in the PTB group. The linear regression equation parameters indicated the slope of the regression line of lung cancer was greater than that of PTB. The ROC curve demonstrated the SUVmax cutoff values of 4.85 and 2.25 for lung cancer and PTB, respectively for predicting the diagnostic accuracy of (18)F‐FDG PET/CT. CONCLUSION: (18)F‐FDG PET/CT has a higher sensitivity and diagnostic accuracy for malignant SPN. However, it has high false‐positive rate and low specificity in tuberculosis endemic areas. Neither SUVmax nor the sizes of the nodules are valuable parameters for distinguishing between lung cancer and PTB. However, the SPN with larger short‐axis and higher SUVmax would be inclined to malignant tumor.
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spelling pubmed-69970902020-02-05 Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country Niyonkuru, Alexandre Chen, Xiaomin Bakari, Khamis Hassan Wimalarathne, Dilani Neranjana Bouhari, Altine Arnous, Maher Mohamad Rajab Lan, Xiaoli Cancer Med Clinical Cancer Research OBJECTIVE: To determine the diagnostic efficacy of (18)F‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB. METHODS: Patients with SPN who underwent (18)F‐FDG PET/CT imaging were retrospectively included in the study. The final diagnosis was established by histopathology. A linear regression equation was fitted to a scatter plot of size and SUVmax of lung cancer and PTB. ROC was used to determine the optimal cutoff values and diagnostic accuracy of (18)F‐FDG PET/CT in PTB and lung cancer. RESULTS: About 514 patients were included with the mean age of 57.5 ± 10.6 years. Four hundred and seventy‐five cases were diagnosed as lung cancer, and 39 cases were PTB by histopathology. (18)F‐FDG PET/CT had sensitivity, specificity, and diagnostic accuracy of 96.0%, 48.7%, and 92.0%, respectively. Utilization of SUVmax ≥2.5 in SPN resulted in 2 and 11 false positives cases of lung cancer and PTB, respectively, whereas SUVmax <2.5 resulted in 18 and 10 false‐positive cases of lung cancer and PTB, respectively. The SUVmax and the size of short‐axis in the lung cancer group were statistically higher than those in the PTB group. The linear regression equation parameters indicated the slope of the regression line of lung cancer was greater than that of PTB. The ROC curve demonstrated the SUVmax cutoff values of 4.85 and 2.25 for lung cancer and PTB, respectively for predicting the diagnostic accuracy of (18)F‐FDG PET/CT. CONCLUSION: (18)F‐FDG PET/CT has a higher sensitivity and diagnostic accuracy for malignant SPN. However, it has high false‐positive rate and low specificity in tuberculosis endemic areas. Neither SUVmax nor the sizes of the nodules are valuable parameters for distinguishing between lung cancer and PTB. However, the SPN with larger short‐axis and higher SUVmax would be inclined to malignant tumor. John Wiley and Sons Inc. 2019-12-13 /pmc/articles/PMC6997090/ /pubmed/31837121 http://dx.doi.org/10.1002/cam4.2770 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Niyonkuru, Alexandre
Chen, Xiaomin
Bakari, Khamis Hassan
Wimalarathne, Dilani Neranjana
Bouhari, Altine
Arnous, Maher Mohamad Rajab
Lan, Xiaoli
Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title_full Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title_fullStr Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title_full_unstemmed Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title_short Evaluation of the diagnostic efficacy of (18)F‐Fluorine‐2‐Deoxy‐D‐Glucose PET/CT for lung cancer and pulmonary tuberculosis in a Tuberculosis‐endemic Country
title_sort evaluation of the diagnostic efficacy of (18)f‐fluorine‐2‐deoxy‐d‐glucose pet/ct for lung cancer and pulmonary tuberculosis in a tuberculosis‐endemic country
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997090/
https://www.ncbi.nlm.nih.gov/pubmed/31837121
http://dx.doi.org/10.1002/cam4.2770
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