Use of PET/CT to aid clinical decision-making in cases of solitary pulmonary nodule: a probabilistic approach

• Published in: Radiologia brasileira Vol. 53; no. 1; pp. 1 - 6
• Main Authors: Mourato, Felipe Alves, Brito, Ana Emília Teixeira, Romão, Monique Sampaio Cruz, Santos, Renata Guerra Galvão, de Almeida, Cristiana Altino, de Almeida Filho, Paulo José, Leal, Aline Lopes Garcia
• Format: Journal Article
• Language: English
• Published: Brazil Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2020
• Subjects: Original; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; Decision support techniques; Medical oncology; Solitary pulmonary nodule; Pulmonary medicine; Clinical decision-making; Positron emission tomography; Tomada de decisão clínica; Tomografia por emissão de pósitrons; Técnicas de suporte a decisão; Oncologia; Pneumologia; Nódulo pulmonar solitário
• ISSN: 0100-3984; 1678-7099; 1678-7099
• DOI: 10.1590/0100-3984.2019.0034

To determine the frequency with which
F-FDG-PET/CT findings change the probability of malignancy classification of solitary pulmonary nodules.
This was a retrospective analysis of all
F-FDG-PET/CT examinations performed for the investigation of a solitary pulmonary nodule between May 2016 and May 2017. We reviewed medical records and PET/CT images to collect the data necessary to calculate the pre-test probability of malignancy using the Swensen model and the Herder model. The probability of malignancy was classified as low if < 5%, intermediate if 5-65%, and high if > 65%. Cases classified as intermediate in the Swensen model were reclassified by the Herder model.
We reviewed the records for 33 patients, of whom 17 (51.5%) were male. The mean age was 68.63 ± 12.20 years. According to the Swensen model, the probability of malignancy was intermediate in 23 cases (69.7%). Among those, the application of the Herder model resulted in the probability of malignancy being reclassified as low in 6 (26.1%) and as high in 8 (34.8%).
F-FDG-PET/CT was able to modify the probability of malignancy classification of a solitary pulmonary nodule in more than 50% of the cases evaluated.