The Role of Positron Emission Tomography/Computed Tomography in the Diagnosis of Pleural Diseases

Abstract

Background: The aim of the study was to assess the role of F-18 fluoro-2-D-deoxyglucose positron emission tomography (¹⁸FDG‐PET)/computed tomography (CT) in patients with undiagnosed pleural diseases and to compare the findings with those of invasive diagnostic procedures. Methods: The study included 83 patients with pleural lesions (63 with pleural effusion; 20 with pleural thickening) on CT scan performed between November 2005 and December 2007. The study group consisted of 63 males and 20 females; their median age was 47 years. PET‐CT scan was performed for all patients before surgery. A maximum standard uptake value greater than 3.0 was accepted as positive for malignancy. For histopathological diagnosis, video-assisted thoracoscopic surgery was performed in 76 patients and a mini-thoracotomy was performed for the remaining 7 patients. Results: Postoperative histopathological examination revealed malignancy in 44 cases, 25 of which were malignant mesothelioma; the remaining 39 cases were benign. There were no false negative results, but two false positive results (tuberculosis). PET‐CT scanning had 100 % sensitivity, 94.8 % specificity and 97.5 % accuracy. Conclusion: Our study suggests that PET‐CT may be an effective tool for the differentiation of benign and malignant pleural diseases. We believe that PET/CT may prevent redundant surgical procedures in young patients who are SUVmax negative.

Key words

PET/CT - pleural diseases - VATS

References

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