Cargando…
(18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules
BACKGROUND: (18)F-fluorodeoxyglucose (FDG) PET/CT is recommended for evaluation of intermediate-risk indeterminate pulmonary nodules (IPNs). While highly sensitive, the specificity of FDG remains suboptimal for differentiating malignant from benign nodules, particularly in areas where fungal lung di...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926263/ https://www.ncbi.nlm.nih.gov/pubmed/35294486 http://dx.doi.org/10.1371/journal.pone.0265427 |
_version_ | 1784670203034992640 |
---|---|
author | Paez, Rafael Shah, Chirayu Cords, Angelina J. Muterspaugh, Anel Helton, John E. Antic, Sanja Eisenberg, Rosana Chen, Heidi Grogan, Eric L. Manning, Henry C. Walker, Ronald C. Massion, Pierre P. |
author_facet | Paez, Rafael Shah, Chirayu Cords, Angelina J. Muterspaugh, Anel Helton, John E. Antic, Sanja Eisenberg, Rosana Chen, Heidi Grogan, Eric L. Manning, Henry C. Walker, Ronald C. Massion, Pierre P. |
author_sort | Paez, Rafael |
collection | PubMed |
description | BACKGROUND: (18)F-fluorodeoxyglucose (FDG) PET/CT is recommended for evaluation of intermediate-risk indeterminate pulmonary nodules (IPNs). While highly sensitive, the specificity of FDG remains suboptimal for differentiating malignant from benign nodules, particularly in areas where fungal lung diseases are prevalent. Thus, a cancer-specific imaging probe is greatly needed. In this study, we tested the hypothesis that a PET radiotracer (S)-4-(3-[(18)F]-fluoropropyl)-L-glutamic acid (FSPG) improves the diagnostic accuracy of IPNs compared to (18)F-FDG PET/CT. METHODS: This study was conducted at a major academic medical center and an affiliated VA medical center. Twenty-six patients with newly discovered IPNs 7-30mm diameter or newly diagnosed lung cancer completed serial PET/CT scans utilizing (18)F-FDG and (18)F-FSPG, without intervening treatment of the lesion. The scans were independently reviewed by two dual-trained diagnostic radiology and nuclear medicine physicians. Characteristics evaluated included quantitative SUVmax values of the pulmonary nodules and metastases. RESULTS: A total of 17 out of 26 patients had cancer and 9 had benign lesions. (18)F-FSPG was negative in 6 of 9 benign lesions compared to 7 of 9 with (18)F-FDG. (18)F-FSPG and (18)F-FDG were positive in 14 of 17 and 12 of 17 malignant lesions, respectively. (18)F-FSPG detected brain and intracardiac metastases missed by (18)F-FDG PET in one case, while (18)F-FDG detected a metastasis to the kidney missed by (18)F-FSPG. CONCLUSION: In this pilot study, there was no significant difference in overall diagnostic accuracy between (18)F-FSPG and (18)F-FDG for the evaluation of IPNs and staging of lung cancer. Additional studies will be needed to determine the clinical utility of this tracer in the management of IPNs and lung cancer. |
format | Online Article Text |
id | pubmed-8926263 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-89262632022-03-17 (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules Paez, Rafael Shah, Chirayu Cords, Angelina J. Muterspaugh, Anel Helton, John E. Antic, Sanja Eisenberg, Rosana Chen, Heidi Grogan, Eric L. Manning, Henry C. Walker, Ronald C. Massion, Pierre P. PLoS One Research Article BACKGROUND: (18)F-fluorodeoxyglucose (FDG) PET/CT is recommended for evaluation of intermediate-risk indeterminate pulmonary nodules (IPNs). While highly sensitive, the specificity of FDG remains suboptimal for differentiating malignant from benign nodules, particularly in areas where fungal lung diseases are prevalent. Thus, a cancer-specific imaging probe is greatly needed. In this study, we tested the hypothesis that a PET radiotracer (S)-4-(3-[(18)F]-fluoropropyl)-L-glutamic acid (FSPG) improves the diagnostic accuracy of IPNs compared to (18)F-FDG PET/CT. METHODS: This study was conducted at a major academic medical center and an affiliated VA medical center. Twenty-six patients with newly discovered IPNs 7-30mm diameter or newly diagnosed lung cancer completed serial PET/CT scans utilizing (18)F-FDG and (18)F-FSPG, without intervening treatment of the lesion. The scans were independently reviewed by two dual-trained diagnostic radiology and nuclear medicine physicians. Characteristics evaluated included quantitative SUVmax values of the pulmonary nodules and metastases. RESULTS: A total of 17 out of 26 patients had cancer and 9 had benign lesions. (18)F-FSPG was negative in 6 of 9 benign lesions compared to 7 of 9 with (18)F-FDG. (18)F-FSPG and (18)F-FDG were positive in 14 of 17 and 12 of 17 malignant lesions, respectively. (18)F-FSPG detected brain and intracardiac metastases missed by (18)F-FDG PET in one case, while (18)F-FDG detected a metastasis to the kidney missed by (18)F-FSPG. CONCLUSION: In this pilot study, there was no significant difference in overall diagnostic accuracy between (18)F-FSPG and (18)F-FDG for the evaluation of IPNs and staging of lung cancer. Additional studies will be needed to determine the clinical utility of this tracer in the management of IPNs and lung cancer. Public Library of Science 2022-03-16 /pmc/articles/PMC8926263/ /pubmed/35294486 http://dx.doi.org/10.1371/journal.pone.0265427 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Paez, Rafael Shah, Chirayu Cords, Angelina J. Muterspaugh, Anel Helton, John E. Antic, Sanja Eisenberg, Rosana Chen, Heidi Grogan, Eric L. Manning, Henry C. Walker, Ronald C. Massion, Pierre P. (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title | (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title_full | (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title_fullStr | (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title_full_unstemmed | (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title_short | (18)F-FSPG PET imaging for the evaluation of indeterminate pulmonary nodules |
title_sort | (18)f-fspg pet imaging for the evaluation of indeterminate pulmonary nodules |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926263/ https://www.ncbi.nlm.nih.gov/pubmed/35294486 http://dx.doi.org/10.1371/journal.pone.0265427 |
work_keys_str_mv | AT paezrafael 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT shahchirayu 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT cordsangelinaj 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT muterspaughanel 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT heltonjohne 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT anticsanja 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT eisenbergrosana 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT chenheidi 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT groganericl 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT manninghenryc 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT walkerronaldc 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules AT massionpierrep 18ffspgpetimagingfortheevaluationofindeterminatepulmonarynodules |