This poster was originally presented at the ESTI 2012 meeting, June 22-24, in London/UK.
www.myESTI.org
Keywords:
Nuclear medicine, Oncology, PET-CT, CT, Outcomes analysis, Comparative studies, Cancer, Neoplasia
Authors:
S. Vaidyanathan, S. Karthik, P. Malhotra, P. Plant, M. Callister, R. Robertson, A. Scarsbrook; Leeds, West Yorkshire/UK
DOI:
10.1594/esti2012/E-0127
Results
•80 nodules in 70 patients with a median (range) age of 70 (46 -87) years,
of whom 44 (55%) were male,
were included.
•Malignancy was confirmed in 19 (24%) patients.
•Data on overall outcomes and between-group outcomes are demonstrated in Table 1.
|
Full sample
(N=80)
|
Malignant
(N=19)
|
Benign
(N=61)
|
P
|
|
|
|
|
|
Clinical
|
|
|
|
|
Age (Median (range),
years)
|
70 (46–87)
|
67 (46–87)
|
73 (49–85)
|
.07
|
|
|
|
|
|
Male (No.,
%)
|
44 (55)
|
34 (53)
|
10 (53)
|
.81
|
|
|
|
|
|
Smoking history (No.,
%)‡
|
|
|
|
.75
|
Current or former smoker
|
63 (82)
|
47 (81)
|
16 (84)
|
|
Never smoked
|
14 (18)
|
11 (19)
|
3 (16)
|
|
|
|
|
|
|
Duration of follow-up (range,
months)
|
24 (2–58)
|
24 (2–54)
|
35 (3–58)
|
.21
|
Radiological
|
|
|
|
|
Location (No.,
%)
|
|
|
|
|
Right lung (No.,
%)
|
43 (54)
|
8 (42)
|
35 (57)
|
.24
|
Upper lobe
|
37 (46)
|
9 (47)
|
28 (46)
|
.91
|
|
|
|
|
|
Nodule size (mm)
|
1.6 (0.99)
|
1.6 (0.64)
|
1.6 (1.1)
|
.84
|
|
|
|
|
|
Outline of nodule (No.,
%)
|
|
|
|
.01†
|
Spiculated
|
23 (29)
|
5 (26)
|
18 (29)
|
|
Lobulated
|
10 (12)
|
6 (32)†
|
4 (7)†
|
|
Smooth
|
47 (59)
|
8 (42)
|
39 (64)
|
|
|
|
|
|
|
Morphology of nodule (No.,
%)
|
|
|
|
.005†
|
Solid
|
71 (89)
|
13 (69)
|
58 (95)
|
|
Sub-solid
|
7 (9)
|
5 (26)†
|
2 (3)
|
|
Pure ground glass
|
2 (2)
|
1 (5)
|
1 (2)
|
|
|
|
|
|
|
SUVmax
|
0.58 (0.92)
|
1.21 (0.90)
|
0.38 (0.80)
|
<.001†
|
|
|
|
|
|
Change on serial imaging (No.,
%)
|
|
|
|
<.001†
|
No change
|
48 (60)
|
2 (10.5)†
|
46 (75)
|
|
Decrease
|
9 (11)
|
0 (0)†
|
9 (15)†
|
|
Increase
|
20 (25)
|
15 (79) †
|
5 (8)
|
|
Resected
|
3 (4)
|
2 (10.5)
|
1 (2)
|
|
|
|
|
|
|
Doubling Time (mean (SD,
months)
|
190 (195)
|
61 (149)
|
197 (290)
|
.94
|
|
|
|
|
|
* Values are arithmetic mean (SD) unless mentioned otherwise.
† Subgroup analyses for P < .05 between groups.
Percentages within parentheses are given as % of benign or malignant.
‡ Smoking status was available for 77/80 patients only.
|
• Of the 24 (30%) SPNs that demonstrated FDG uptake,
mean (SD) SUVmax was 0.58 (0.92).
•48 (60%) nodules were unchanged after 2 years,
9 (11.3%) decreased or resolved,
20 (25%) increased and 3 (3.8%) were resected.
46 of the 48 unchanged nodules were benign ( Fig. 1 ),
9/9 nodules that decreased were benign ( Fig. 2 ) and 15/20 nodules that increased were malignant ( Fig. 3 ).
•Using a multi-variate regression analysis,
sub-solid nodule morphology,
SUVmax and faster doubling-time were significant predictors of malignancy.
•ROC curve analysis (AUC = 0.71) estimated a sensitivity of 52.6% and specificity of 82% with an SUVmax > 1.45 ( Fig. 4 ).