TY - JOUR
T1 - Differentiation of malignant and benign pulmonary nodules with quantitative first-pass 320-detector row perfusion CT versus FDG PET/CT
AU - Ohno, Yoshiharu
AU - Koyama, Hisanobu
AU - Matsumoto, Keiko
AU - Onishi, Yumiko
AU - Takenaka, Daisuke
AU - Fujisawa, Yasuko
AU - Yoshikawa, Takeshi
AU - Konishi, Minoru
AU - Maniwa, Yoshimasa
AU - Nishimura, Yoshihiro
AU - Ito, Tomoo
AU - Sugimura, Kazuro
PY - 2011/2
Y1 - 2011/2
N2 - Purpose: To prospectively compare the capability of quantitative first-pass perfusion 320-detector row computed tomography (CT) (ie, area-detector CT) with that of combined positron emission tomography and CT (PET/CT) for differentiation between malignant and benign pulmonary nodules. Materials and Methods: This prospective study was approved by the institutional review board, and written informed consent was obtained from 50 consecutive patients with 76 pulmonary nodules. All patients underwent dynamic area-detector CT, PET/CT, and microbacterial and/or histopathologic examinations. All pulmonary nodules were divided into three groups: malignant nodules(n = 43), benign nodules with low biologic activity(n = 6), and benign nodules with high biologic activity(n = 27). For each dynamic area-detector CT data set, the perfusion derived by using the maximum slope model (PFMS), extraction fraction derived by using the Patlak plot model (EFPP), and blood volume derived by using the Patlak plot model (BVPP) were calculated. These parameters were statistically compared among the three nodule groups. Receiver operating characteristic (ROC) analyses were used to compare the diagnostic capability of the CT and PET/CT indexes. Finally, the sensitivity, specificity, and accuracy of each index were compared by using the McNemar test. Results: All indexes in the malignant nodule group were significantly different from those in the low-biologic-activity benign nodule group (P < .05). Areas under the ROC curve for PFMS and EFPP were significantly larger than those for BVPP (P < .05) and maximal standard uptake value (SUV max ) (P < .05). The specificity and accuracy of PFMS and EF PP were significantly higher than those of BVPP and SUVmax (P < .05). Conclusion: Dynamic first-pass area-detector perfusion CT has the potential to be more specific and accurate than PET/CT for differentiating malignant from benign pulmonary nodules.
AB - Purpose: To prospectively compare the capability of quantitative first-pass perfusion 320-detector row computed tomography (CT) (ie, area-detector CT) with that of combined positron emission tomography and CT (PET/CT) for differentiation between malignant and benign pulmonary nodules. Materials and Methods: This prospective study was approved by the institutional review board, and written informed consent was obtained from 50 consecutive patients with 76 pulmonary nodules. All patients underwent dynamic area-detector CT, PET/CT, and microbacterial and/or histopathologic examinations. All pulmonary nodules were divided into three groups: malignant nodules(n = 43), benign nodules with low biologic activity(n = 6), and benign nodules with high biologic activity(n = 27). For each dynamic area-detector CT data set, the perfusion derived by using the maximum slope model (PFMS), extraction fraction derived by using the Patlak plot model (EFPP), and blood volume derived by using the Patlak plot model (BVPP) were calculated. These parameters were statistically compared among the three nodule groups. Receiver operating characteristic (ROC) analyses were used to compare the diagnostic capability of the CT and PET/CT indexes. Finally, the sensitivity, specificity, and accuracy of each index were compared by using the McNemar test. Results: All indexes in the malignant nodule group were significantly different from those in the low-biologic-activity benign nodule group (P < .05). Areas under the ROC curve for PFMS and EFPP were significantly larger than those for BVPP (P < .05) and maximal standard uptake value (SUV max ) (P < .05). The specificity and accuracy of PFMS and EF PP were significantly higher than those of BVPP and SUVmax (P < .05). Conclusion: Dynamic first-pass area-detector perfusion CT has the potential to be more specific and accurate than PET/CT for differentiating malignant from benign pulmonary nodules.
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U2 - 10.1148/radiol.10100245
DO - 10.1148/radiol.10100245
M3 - Article
C2 - 21273522
AN - SCOPUS:79952340035
SN - 0033-8419
VL - 258
SP - 599
EP - 609
JO - Radiology
JF - Radiology
IS - 2
ER -