The Role of PET/CT in Assessing Pulmonary Nodules in Children With Solid Malignancies

The Role of PET/CT in Assessing Pulmonary Nodules in Children With Solid Malignancies

Author McCarville, M. Beth Google Scholar
Billups, Catherine Google Scholar
Wu, Jianrong Google Scholar
Kaufman, Robert Google Scholar
Kaste, Sue Google Scholar
Coleman, Jamie Google Scholar
Sharp, Susan Google Scholar
Nadel, Helen Google Scholar
Charron, Martin Google Scholar
Lederman, Henrique Autor UNIFESP Google Scholar
Don, Steven Google Scholar
Shochat, Stephen Google Scholar
Daw, Najat C. Google Scholar
Shulkin, Barry Google Scholar
Institution St Jude Childrens Res Hosp
Cincinnati Childrens Hosp Med Ctr
British Columbia Childrens Hosp
Hosp Sick Children
Universidade Federal de São Paulo (UNIFESP)
St Louis Childrens Hosp
Abstract OBJECTIVE. the purpose of this article is to assess the feasibility and utility of PET/CT in distinguishing benign from malignant pulmonary nodules in patients with solid childhood malignancies.SUBJECTS and METHODS. This prospective study was conducted between March 2008 and August 2010. We enrolled 25 subjects 21 years old or younger with solid childhood malignancies and at least one pulmonary nodule measuring 0.5-3.0 cm. PET/CT was performed within 3 weeks of diagnostic chest CT. Three panels of three reviewers each reviewed diagnostic CT only (panel 1), PET/CT only (panel 2), or diagnostic CT and PET/CT concurrently (panel 3) and predicted each nodule's histologic diagnosis as benign, malignant, or indeterminate. Interreviewer agreement was assessed with the kappa statistic. Using nodule biopsy or clinical follow-up as reference standards, the sensitivity, specificity, and accuracy for each panel was assessed. Logistic regression was used to assess the nodule's maximum standardized uptake value (SUVmax) association with its histologic diagnosis.RESULTS. There were 75 nodules with a median size of 0.74 cm (range, 0.18-2.38 cm); 48 nodules were malignant. Sensitivity was 85% (41/48) for panel 1, 60% (29/48) for panel 2, and 67% (32/48) for panel 3. All panels had poor specificities. Interreviewer agreement was moderate for panel 1 (0.43) and poor for panels 2 (0.22) and 3 (0.33). SUVmax was a significant predictor of histologic diagnosis (p = 0.004).CONCLUSION. PET/CT assessment of pulmonary nodules is feasible in children with solid malignancies but may not reliably improve our ability to predict a nodule's histologic diagnosis. the SUVmax may improve the performance of PET/CT in this setting.
Keywords children
pulmonary nodules
solid malignancies
Language English
Sponsor Society for Pediatric Radiology, Research and Education Foundation (Dorst-Fleischer Grant)
Date 2013-12-01
Published in American Journal of Roentgenology. Reston: Amer Roentgen Ray Soc, v. 201, n. 6, p. W900-W905, 2013.
ISSN 0361-803X (Sherpa/Romeo, impact factor)
Publisher Amer Roentgen Ray Soc
Extent W900-W905
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000327501500013

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