Chest
Clinical InvestigationsNUCLEAR MEDICINEEvaluation of Pleural Disease With 18-Fluorodeoxyglucose Positron Emission Tomography Imaging
Section snippets
Patient Selection
Ninety-eight consecutive patients presenting exudative pleural effusion and/or pleural thickening (mean age, 60.9 years; range, 36 to 83 years; 67 men and 31 women) were investigated. In all these patients, the combination of chest radiograph, thoracic CT scanning (PQ 2000 Fourth Generation; Picker; Cleveland, OH) and thoracocentesis failed to give an etiologic diagnosis. Sixty-seven patients had pleural effusion, 10 patients had diffuse pleural thickening, 2 patients had localized pleural
Results
The nature of pleural lesion was diagnosed from cytologic and histologic specimens obtained with blind-needle biopsy, thoracoscopy, and open surgical biopsy in 17, 62, and 5 subjects, respectively. In the remaining 14 patients, no specific histologic pattern other than pleural inflammation was observed. Because of the clinical context in these patients, no further invasive procedure was believed to be indicated, and the decision was made to classify the patient as having benign pleural disease.
Discussion
Little is known about application of FDG-PET imaging to the management of pleural disease. Our results indicate that FDG-PET is a useful tool to differentiate between benign and malignant pleural lesions. We confirm in a large series of patients our primary study1819 and the sparse data available20212223 involving small number of patients. Indeed, this technique has sensitivity and negative predictive value > 90% in diagnosing malignancy. With a sensitivity of 97%, PET-FDG is by far superior to
ACKNOWLEDGMENT
We thank Dr. Garry Harstein for reviewing the manuscript.
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Dr. Cataldo is a postdoctoral researcher from the Belgian National Fund for Scientific Research (FNRS), Belgium.