AIM: Evaluate the role of positron emission tomography (PET), fiberopticbronchoscopy (FOB) and PET+FOB in the diagnosis of solitary pulmonary nodules (SPN). METHODS: A prospective study was performed in 58 patients (6 were excluded) with SPNwho underwent PET and FOB for lesion differentiation. FOB included transbronchial pulmonary biopsy (TBB), trans-bronchial pulmonary needle aspiration (TBNAp) and bronchial washing (BW). PET was positive when the standardized uptake value was ≥2.5, and FOB and the PET and FOB combination was positive when at least TBB, TBNA or BW was positive. The results were confirmed through histology after surgery or clinical follow-up. The sensitivity, specificity, accuracy, PPV and NPV of PET, FOB and PET+FOB were calculated. RESULTS: Out of 52 patients, PET, FOB and PET+FOB resulted a true positive (TP) in 42, 20 and 42 cases, respectively, true negative (TN) in 6, 7 and 6 cases, false positive (FP) in 1, 0 and 1 cases, and false negative (FN) in 5, 25 and 3 cases. PET was FP in 1 TN FOB case and FN in 2 TP FOB cases. FOB was FN in 25 cases; 22 out of 25 were TP PET. The diagnostic performance of PET, FOB and PET+FOB were as follows: sensitivity 89%, 44% and 93%, respectively; specificity 86%, 100% and 86%; accuracy 89%, 52% and 92%; PPV (positive predictive value) 97%, 100% and 97%; NPV (negative predictive value) 54%, 21% and 66%. CONCLUSION: PET+FOB showed a high sensitivity, accuracy and NPV compared to PET and FOB alone. PET has a high sensitivity but is not tumor-specific. FOB could be indicated for its high specificity and PPV.
Value of fiberoptic bronchoscopy in addition to 18F-FDG-PET/CT in the differentiation of solitary pulmonary nodules: a prospective study
CONTI, Valentina;MARCHI, Martina;PETERLE, Chiara;CITTANTI, Corrado;CONTOLI, Marco;PAPI, Alberto;
2015
Abstract
AIM: Evaluate the role of positron emission tomography (PET), fiberopticbronchoscopy (FOB) and PET+FOB in the diagnosis of solitary pulmonary nodules (SPN). METHODS: A prospective study was performed in 58 patients (6 were excluded) with SPNwho underwent PET and FOB for lesion differentiation. FOB included transbronchial pulmonary biopsy (TBB), trans-bronchial pulmonary needle aspiration (TBNAp) and bronchial washing (BW). PET was positive when the standardized uptake value was ≥2.5, and FOB and the PET and FOB combination was positive when at least TBB, TBNA or BW was positive. The results were confirmed through histology after surgery or clinical follow-up. The sensitivity, specificity, accuracy, PPV and NPV of PET, FOB and PET+FOB were calculated. RESULTS: Out of 52 patients, PET, FOB and PET+FOB resulted a true positive (TP) in 42, 20 and 42 cases, respectively, true negative (TN) in 6, 7 and 6 cases, false positive (FP) in 1, 0 and 1 cases, and false negative (FN) in 5, 25 and 3 cases. PET was FP in 1 TN FOB case and FN in 2 TP FOB cases. FOB was FN in 25 cases; 22 out of 25 were TP PET. The diagnostic performance of PET, FOB and PET+FOB were as follows: sensitivity 89%, 44% and 93%, respectively; specificity 86%, 100% and 86%; accuracy 89%, 52% and 92%; PPV (positive predictive value) 97%, 100% and 97%; NPV (negative predictive value) 54%, 21% and 66%. CONCLUSION: PET+FOB showed a high sensitivity, accuracy and NPV compared to PET and FOB alone. PET has a high sensitivity but is not tumor-specific. FOB could be indicated for its high specificity and PPV.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
