¹⁸F-fluoro-deoxy-glucose focal uptake in very small pulmonary nodules: fact or artifact? Case reports.

Details

Serval ID
serval:BIB_876F9FEA9C7E
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
¹⁸F-fluoro-deoxy-glucose focal uptake in very small pulmonary nodules: fact or artifact? Case reports.
Journal
World journal of surgical oncology
Author(s)
Calcagni M.L., Taralli S., Maggi F., Rufini V., Treglia G., Leccisotti L., Bonomo L., Giordano A.
ISSN
1477-7819 (Electronic)
ISSN-L
1477-7819
Publication state
Published
Issued date
28/04/2012
Peer-reviewed
Oui
Volume
10
Pages
71
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Abstract
18F-fluoro-deoxy-glucose (18 F-FDG) positron emission tomography integrated/combined with computed tomography (PET-CT) provides the best diagnostic results in the metabolic characterization of undetermined solid pulmonary nodules. The diagnostic performance of 18 F-FDG is similar for nodules measuring at least 1 cm and for larger masses, but few data exist for nodules smaller than 1 cm.
We report five cases of oncologic patients showing focal lung 18 F-FDG uptake on PET-CT in nodules smaller than 1 cm. We also discuss the most common causes of 18 F-FDG false-positive and false-negative results in the pulmonary parenchyma.In patient 1, contrast-enhanced CT performed 10 days before PET-CT did not show any abnormality in the site of uptake; in patient 2, high-resolution CT performed 1 month after PET showed a bronchiole filled with dense material interpreted as a mucoid impaction; in patient 3, contrast-enhanced CT performed 15 days before PET-CT did not identify any nodules; in patients 4 and 5, contrast-enhanced CT revealed a nodule smaller than 1 cm which could not be characterized. The 18 F-FDG uptake at follow-up confirmed the malignant nature of pulmonary nodules smaller than 1 cm which were undetectable, misinterpreted, not recognized or undetermined at contrast-enhanced CT.
In all five oncologic patients, 18 F-FDG was able to metabolically characterize as malignant those nodules smaller than 1 cm, underlining that: 18 F-FDG uptake is not only a function of tumor size but it is strongly related to the tumor biology; functional alterations may precede morphologic abnormalities. In the oncologic population, especially in higher-risk patients, PET can be performed even when the nodules are smaller than 1 cm, because it might give an earlier characterization and, sometimes, could guide in the identification of alterations missed on CT.

Keywords
Aged, Aged, 80 and over, Carcinoma, Squamous Cell/diagnostic imaging, Carcinoma, Squamous Cell/pathology, False Negative Reactions, False Positive Reactions, Fatal Outcome, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms/diagnostic imaging, Lung Neoplasms/pathology, Male, Multimodal Imaging, Multiple Pulmonary Nodules/diagnostic imaging, Multiple Pulmonary Nodules/pathology, Positron-Emission Tomography, Radiopharmaceuticals, Solitary Pulmonary Nodule/diagnostic imaging, Solitary Pulmonary Nodule/pathology, Tomography, X-Ray Computed, Tumor Burden
Pubmed
Web of science
Open Access
Yes
Create date
20/08/2017 21:00
Last modification date
20/08/2019 14:46
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