Preliminary study on the correlation between grading and histology of solitary pulmonary nodules and contrast enhancement and [18F]fluorodeoxyglucose standardised uptake value after evaluation by dynamic multiphase CT and PET/CT.

Abstract

AIM:

To evaluate whether the histology and grading of solitary pulmonary nodules (SPNs) correlated with the results of dynamic multiphase multidetector CT (MDCT) and the [(18)F]fluorodeoxyglucose standardised uptake value (SUV) in 30 patients.

METHODS:

Chest x-rays of 270 patients with incidentally detected SPNs were retrospectively evaluated. Thirty patients with histologically proven SPNs were enrolled. On MDCT and positron emission tomography (PET)/CT images, two experts measured the density of nodules in all perfusion phases and the SUV. Net enhancement (NE) was calculated by subtracting peak pre-contrast density from peak post-contrast density. The Pearson test was used to correlate nodule NE, SUV, grading, histology and diameter.

RESULTS:

Of the 30 malignant SPNs, six were classified as G1 (median NE, 31.5 Hounsfield units (HU); median SUV, 4.8 units), 15 were classified as G2 (median NE, 49 HU; median SUV, 6 units), and nine were classified as G3 (median NE, 32 HU; median SUV, 4.5 units). A highly negative correlation was found in G3 SPNs between NE and the corresponding diameters (r=-0.834; p=0.00524). NE increased with the increase in diameter (r=0.982; p=0.284). SUV increased as the SPN diameter increased (r=0.789; p=0.421). NE and SUV were higher in G2 than G1 SPNs, and lower in G2 than G3 SPNs (r=0.97; p=0.137).

CONCLUSIONS:

The significant correlation in dedifferentiated (G3) SPNs between NE and diameter (r=-0.834; p=0.00524) supports the theory that stroma and neoangiogenesis are fundamental in SPN growth. The highly negative correlation between NE and diameter demonstrates a net decrease in perfusion despite an increase in dimension. The multidisciplinary approach used herein may result in a more precise prognosis and consequently a better therapeutic outcome, particularly in patients with undifferentiated lung cancer.

• Authors: Salvatore Cappabianca, Annamaria Porto, Mario Petrillo, Barbara Greco, Alfonso Reginelli, Francesco Ronza, Francesca Setola, Giovanni Rossi, Andrea Di Matteo, Roberto Muto, Maria Luisa De Rimini, Sergio Piccolo, Mara Catalano, Pietro Muto, Nicoletta De Rosa, Enrica Barra, Ilaria De Rosa, Francesca Antinolfi, Giuseppe Antinolfi, Mario Caputi, Luca Brunese, Roberto Grassi, Antonio Rotondo
• Journal: Journal of clinical pathology (J Clin Pathol) Vol. 64 Issue 2 Pg. 114-9 (Feb 2011) ISSN: 1472-4146 [Electronic] England
• PMID: 21169276 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adenocarcinoma (blood supply, diagnosis, pathology)
• Aged
• Aged, 80 and over
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Humans
• Lung Neoplasms (blood supply, diagnosis, pathology)
• Male
• Middle Aged
• Neovascularization, Pathologic (diagnosis, pathology)
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals (pharmacokinetics)
• Retrospective Studies
• Solitary Pulmonary Nodule (blood supply, diagnosis, pathology)
• Tomography, X-Ray Computed (methods)