Solitary pulmonary nodules differentiated by Dynamic F-18 FDG PET in a region with high prevalence of granulomatous disease

Yu Erh Huang, Hung I. Lu, Feng Yuan Liu, Yu Jie Huang, Meng Chih Lin, Chin Feng Chen, Pei Wen Wang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

26 Scopus citations


This study determined whether dynamic F-18 FDG PET imaging could differentiate benign from malignant solitary pulmonary nodules (SPNs). Histopathologically confirmed SPNs (10-35 mm), 24 malignant and 10 benign, from 34 patients were studied through both dynamic and static F-18 FDG PET imaging of all patients. Volumes of interest (VOIs) were placed over the pulmonary nodules using a 50% maximum pixel value threshold. The arterial input function was estimated from a left ventricle-defined VOL Based on Patlak analysis, we calculated the net FDG phosphorylation rate (K1) and glucose metabolic rate (MRGlu) of each nodule. The slope values of the time-activity curves (TACs) of the nodules were also determined. Based on the static PET images, maximum and mean standardized uptake values (SUVmax and SUVmean, respectively) were calculated. Benign and malignant SPNs had significantly different values for SUVmax, SUVmean, Kj, MRGlu, and TAC slope, with area under the receiver operating characteristic curves distinguishing benign from malignant nodules. McNemar's test of marginal homogeneity found all the predictors helpful to detect malignant nodules (all, p > 0.05), and combining Ki and MRGlu, which were generated by dynamic study, yielded a higher specificity of 90%, and a sensitivity of 79%. Among the 10 benign nodules, static SUV imaging correctly classified seven, while dynamic F-18 PET imaging correctly classified nine. Dynamic F-18 FDG PET imaging is valuable in differentiating benign from malignant SPNs, particularly for granulomatous disease.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalJournal of Radiation Research
Issue number2
StatePublished - 03 2012


  • F-18 fluorodeoxyglucose
  • Kinetic analysis
  • Positron emission tomography
  • Solitary pulmonary nodules


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