Saudi medical journal · 2026
The Role of F-18 FDG PET/CT in the Evaluation of Solitary Pulmonary Nodules.
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Cetinkaya Erdal, Guzel Fatih, Tuzcu Sadiye Altun, Cetin Ilbey Erkin, Ibiloglu Ibrahim, Argin Esref, Cetin Feray Altun, Tasdemir Bekir
Аннотация
OBJECTIVE: Fluorine-18 fluorodeoxyglucose positronemissiontomography/computedtomography (F-18 FDG PET/CT) is commonly used in the evaluation of solitary pulmonary nodules (SPNs). This study aimed to investigate the predictive value of maximum standardized uptake value (SUVmax) and its ratios to liver and mediastinal blood pool SUVmax values for malignancy in SPNs, using histopathological findings as the reference standard.
METHODS: The study included 130 patients who underwent F-18 FDG PET/CT and had either histopathological confirmation or at least two years of radiological follow-up. Demographic data (age and sex), nodule size, location, contour characteristics, nodule SUVmax, nodule-to-liver SUVmax ratio (NLR), and nodule-to-mediastinal blood pool SUVmax ratio (NBR) were recorded. Nodules were classified as benign or malignant based on histopathological results.
RESULTS: Among the 83 patients with histopathological diagnosis, 54% (n = 44) had malignant lesions and 46% (n = 39) had benign lesions. The mean size of malignant nodules was approximately 20 mm. Receiver operating characteristic (ROC) analysis demonstrated that an SUVmax cutoff value of 4.02 provided the highest diagnostic accuracy for predicting malignancy. Both NLR and NBR showed significant diagnostic value in malignancy prediction. These parameters demonstrated high sensitivity (84-91%) and negative predictive value (76-84%), indicating their usefulness in excluding benign nodules.
CONCLUSION: The F-18 FDG PET/CT is a valuable imaging modality in the evaluation of solitary pulmonary nodules. In addition to SUVmax, the use of NLR and NBR may improve diagnostic accuracy and contribute to clinical decision-making.
METHODS: The study included 130 patients who underwent F-18 FDG PET/CT and had either histopathological confirmation or at least two years of radiological follow-up. Demographic data (age and sex), nodule size, location, contour characteristics, nodule SUVmax, nodule-to-liver SUVmax ratio (NLR), and nodule-to-mediastinal blood pool SUVmax ratio (NBR) were recorded. Nodules were classified as benign or malignant based on histopathological results.
RESULTS: Among the 83 patients with histopathological diagnosis, 54% (n = 44) had malignant lesions and 46% (n = 39) had benign lesions. The mean size of malignant nodules was approximately 20 mm. Receiver operating characteristic (ROC) analysis demonstrated that an SUVmax cutoff value of 4.02 provided the highest diagnostic accuracy for predicting malignancy. Both NLR and NBR showed significant diagnostic value in malignancy prediction. These parameters demonstrated high sensitivity (84-91%) and negative predictive value (76-84%), indicating their usefulness in excluding benign nodules.
CONCLUSION: The F-18 FDG PET/CT is a valuable imaging modality in the evaluation of solitary pulmonary nodules. In addition to SUVmax, the use of NLR and NBR may improve diagnostic accuracy and contribute to clinical decision-making.