Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules. Our experience on 1592 patients
Articolo
Data di Pubblicazione:
2017
Citazione:
Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules. Our experience on 1592 patients / 60) Divisi, D., Barone, M., Bertolaccini, L., Rocco, G., Solli, P., Crisci, R., Stefani, A.. - In: JOURNAL OF THORACIC DISEASE. - ISSN 2072-1439. - 9:8(2017), pp. 2551-2559. [10.21037/jtd.2017.06.124]
Abstract:
Background: Multislice computed tomography (MSCT) increased detection of solitary pulmonary
nodules (SPNs), changing the management based on radiological and clinical factors. When 18-fluorine
fluorodeoxyglucose positron emission tomography combined with computed tomography (18F-FDG-PET/CT)
was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5
is used frequently as a cut off for malignancy. The purpose of this study is to evaluate SUVmax PET/CT and
pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological
characteristics of the lesion.
Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian
Registry of VATS Lobectomies.
Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or
second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases
(pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of
the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were
related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age,
nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively).
Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to
the propensity to lymph node metastases.
nodules (SPNs), changing the management based on radiological and clinical factors. When 18-fluorine
fluorodeoxyglucose positron emission tomography combined with computed tomography (18F-FDG-PET/CT)
was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5
is used frequently as a cut off for malignancy. The purpose of this study is to evaluate SUVmax PET/CT and
pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological
characteristics of the lesion.
Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian
Registry of VATS Lobectomies.
Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or
second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases
(pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of
the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were
related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age,
nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively).
Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to
the propensity to lymph node metastases.
Tipologia CRIS:
Articolo su rivista
Keywords:
Solitary pulmonary nodule (SPN); maximum standardized uptake value; ground glass opacities; lymph
node metastases; lung adenocarcinoma
Elenco autori:
60) Divisi, D; Barone, M; Bertolaccini, L; Rocco, G; Solli, P; Crisci, R; Stefani, A
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