Abstract
As a noninvasive functional and anatomical imaging modality, PET/CT could provide additional information reflecting the biological features of lung cancer as well as anatomical information. In advanced lung cancers, PET/CT has showed unique values in diagnosis, staging, predictive analysis, and outcome assessment. With the development of lung cancer screening, the detection rate of small pulmonary nodules measuring less than 10 mm in diameter is increasing. The diagnosis and differential diagnosis of these subcentimeter pulmonary nodules are challenging. Numerous studies have conducted to evaluate the performance of PET/CT in small-sized early-stage NSCLC. In this chapter, we are going to elaborate on the advances of PET/CT clinical applications on small-sized pulmonary nodules, especially subcentimeter lung cancers.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Fletcher JW, Kymes SM, Gould M, Alazraki N, Coleman RE, Lowe VJ, Marn C, Segall G, Thet LA, Lee K. A comparison of the diagnostic accuracy of 18F-FDG PET and CT in the characterization of solitary pulmonary nodules. J Nucl Med. 2008;49(2):179–85. https://doi.org/10.2967/jnumed.107.044990.
Barger RL Jr, Nandalur KR. Diagnostic performance of dual-time 18F-FDG PET in the diagnosis of pulmonary nodules: a meta-analysis. Acad Radiol. 2012;19(2):153–8. https://doi.org/10.1016/j.acra.2011.10.009.
Fischer B, Lassen U, Mortensen J, Larsen S, Loft A, Bertelsen A, Ravn J, Clementsen P, Hogholm A, Larsen K, Rasmussen T, Keiding S, Dirksen A, Gerke O, Skov B, Steffensen I, Hansen H, Vilmann P, Jacobsen G, Backer V, Maltbaek N, Pedersen J, Madsen H, Nielsen H, Hojgaard L. Preoperative staging of lung cancer with combined PET-CT. N Engl J Med. 2009;361(1):32–9. https://doi.org/10.1056/NEJMoa0900043.
van Tinteren H, Hoekstra OS, Smit EF, van den Bergh JH, Schreurs AJ, Stallaert RA, van Velthoven PC, Comans EF, Diepenhorst FW, Verboom P, van Mourik JC, Postmus PE, Boers M, Teule GJ. Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet. 2002;359(9315):1388–93.
Suggested Readings
Balogova S, Huchet V, Kerrou K, Nataf V, Gutman F, Antoine M, Ruppert AM, Prignon A, Lavolee A, Montravers F, Mayaud C, Cadranel J, Talbot JN. Detection of bronchioloalveolar cancer by means of PET/CT and 18F-fluorocholine, and comparison with 18F-fluorodeoxyglucose. Nucl Med Commun. 2010;31(5):389–97. https://doi.org/10.1097/MNM.0b013e3283369654.
Buchbender C, Herbrik M, Treffert J, Forsting M, Bockisch A, Antoch G, Heusner TA. Virtual 18F-FDG PET/CT bronchoscopy for lymph node staging in non-small-cell lung cancer patients: present and future applications. Expert Rev Med Devices. 2012;9(3):241–7. https://doi.org/10.1586/erd.12.9.
Cha MJ, Lee KS, Kim HS, Lee SW, Jeong CJ, Kim EY, Lee HY. Improvement in imaging diagnosis technique and modalities for solitary pulmonary nodules: from ground-glass opacity nodules to part-solid and solid nodules. Expert Rev Respir Med. 2016;10(3):261–78. https://doi.org/10.1586/17476348.2016.1141053.
Chao F, Zhang H. PET/CT in the staging of the non-small-cell lung cancer. J Biomed Biotechnol. 2012;2012:783739. https://doi.org/10.1155/2012/783739.
Chiu CF, Lin YY, Hsu WH, Chen CY, Yeh JJ, Kao CH. Shorter-time dual-phase FDG PET/CT in characterizing solid or ground-glass nodules based on surgical results. Clin Imaging. 2012;36(5):509–14. https://doi.org/10.1016/j.clinimag.2011.11.032.
Chun EJ, Lee HJ, Kang WJ, Kim KG, Goo JM, Park CM, Lee CH. Differentiation between malignancy and inflammation in pulmonary ground-glass nodules: the feasibility of integrated (18)F-FDG PET/CT. Lung Cancer. 2009;65(2):180–6. https://doi.org/10.1016/j.lungcan.2008.11.015.
Divisi D, Barone M, Zaccagna G, Crisci R. Fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a review. Ann Med. 2017;49:626–35. https://doi.org/10.1080/07853890.2017.1339906.
Gomez-Caro A, Boada M, Cabanas M, Sanchez M, Arguis P, Lomena F, Ramirez J, Molins L. False-negative rate after positron emission tomography/computer tomography scan for mediastinal staging in cI stage non-small-cell lung cancer. Eur J Cardiothorac Surg. 2012;42(1):93–100; discussion 100. https://doi.org/10.1093/ejcts/ezr272.
Gould MK, Ananth L, Barnett PG. A clinical model to estimate the pretest probability of lung cancer in patients with solitary pulmonary nodules. Chest. 2007;131(2):383–8. https://doi.org/10.1378/chest.06-1261.
Gould MK, Donington J, Lynch WR, Mazzone PJ, Midthun DE, Naidich DP, Wiener RS. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e93S–e120S. https://doi.org/10.1378/chest.12-2351.
Hattori A, Matsunaga T, Takamochi K, Oh S, Suzuki K. Clinical significance of positron emission tomography in subcentimeter non-small cell lung cancer. Ann Thorac Surg. 2017;103(5):1614–20. https://doi.org/10.1016/j.athoracsur.2016.09.059.
Hattori A, Suzuki K, Matsunaga T, Fukui M, Tsushima Y, Takamochi K, Oh S. Tumour standardized uptake value on positron emission tomography is a novel predictor of adenocarcinoma in situ for c-stage IA lung cancer patients with a part-solid nodule on thin-section computed tomography scan. Interact Cardiovasc Thorac Surg. 2014;18(3):329–34. https://doi.org/10.1093/icvts/ivt500.
Kernstine KH, Grannis FW Jr, Rotter AJ. Is there a role for PET in the evaluation of subcentimeter pulmonary nodules? Semin Thorac Cardiovasc Surg. 2005;17(2):110–4. https://doi.org/10.1053/j.semtcvs.2005.04.004.
Kozower BD, Meyers BF, Reed CE, Jones DR, Decker PA, Putnam JB Jr. Does positron emission tomography prevent nontherapeutic pulmonary resections for clinical stage IA lung cancer? Ann Thorac Surg. 2008;85(4):1166–1169; discussion 1169-1170. https://doi.org/10.1016/j.athoracsur.2008.01.018.
Lasnon C, Hicks RJ, Beauregard JM, Milner A, Paciencia M, Guizard AV, Bardet S, Gervais R, Lemoel G, Zalcman G, Aide N. Impact of point spread function reconstruction on thoracic lymph node staging with 18F-FDG PET/CT in non-small cell lung cancer. Clin Nucl Med. 2012;37(10):971–6. https://doi.org/10.1097/RLU.0b013e318251e3d1.
Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Uno K, Iinuma T, Murano T, Nakashima R, Inoue T. Detection of lung cancer by FDG-PET cancer screening program: a nationwide Japanese survey. Anticancer Res. 2014;34(1):183–9.
Murakami S, Saito H, Sakuma Y, Kondo T, Oshita F, Ito H, Tsuboi M, Hasegawa C, Yokose T, Kameda Y, Nakayama H, Yamada K. Prognostic value of preoperative FDG-PET in stage IA lung adenocarcinoma. Eur J Radiol. 2012;81(8):1891–5. https://doi.org/10.1016/j.ejrad.2011.04.007.
Naidich DP, Bankier AA, MacMahon H, Schaefer-Prokop CM, Pistolesi M, Goo JM, Macchiarini P, Crapo JD, Herold CJ, Austin JH, Travis WD. Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner society. Radiology. 2013;266(1):304–17. https://doi.org/10.1148/radiol.12120628.
Nair VS, Barnett PG, Ananth L, Gould MK. PET scan 18F-fluorodeoxyglucose uptake and prognosis in patients with resected clinical stage IA non-small cell lung cancer. Chest. 2010;137(5):1150–6. https://doi.org/10.1378/chest.09-2356.
Nitadori J, Bograd AJ, Morales EA, Rizk NP, Dunphy MP, Sima CS, Rusch VW, Adusumilli PS. Preoperative consolidation-to-tumor ratio and SUVmax stratify the risk of recurrence in patients undergoing limited resection for lung adenocarcinoma </=2 cm. Ann Surg Oncol. 2013;20(13):4282–8. https://doi.org/10.1245/s10434-013-3212-2.
Ost D, Fein AM, Feinsilver SH. Clinical practice. The solitary pulmonary nodule. N Engl J Med. 2003;348(25):2535–42. https://doi.org/10.1056/NEJMcp012290.
Park HK, Jeon K, Koh WJ, Suh GY, Kim H, Kwon OJ, Chung MP, Lee KS, Shim YM, Han J, Um SW. Occult nodal metastasis in patients with non-small cell lung cancer at clinical stage IA by PET/CT. Respirology. 2010;15(8):1179–84. https://doi.org/10.1111/j.1440-1843.2010.01793.x.
Park SY, Cho A, WS Y, Lee CY, Lee JG, Kim DJ, Chung KY. Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer. J Nucl Med. 2015;56(1):45–9. https://doi.org/10.2967/jnumed.114.147561.
Qiu ZX, Cheng Y, Liu D, Wang WY, Wu X, WL W, Li WM. Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography. Ther Clin Risk Manag. 2016;12:1445–53. https://doi.org/10.2147/tcrm.s110363.
Saisho S, Yasuda K, Maeda A, Yukawa T, Okita R, Hirami Y, Shimizu K, Nakata M. Role of 2-[18F]fluoro-2-deoxyglucose positron emission tomography in preoperative management of solid-type small-sized lung cancer. Ann Nucl Med. 2013;27(6):515–22. https://doi.org/10.1007/s12149-013-0715-7.
Sayyouh M, Vummidi DR, Kazerooni EA. Evaluation and management of pulmonary nodules: state-of-the-art and future perspectives. Expert Opin Med Diagn. 2013;7(6):629–44. https://doi.org/10.1517/17530059.2013.858117.
Shibata H, Nomori H, Uno K, Iyama K, Tomiyoshi K, Nakashima R, Sakaguchi K, Goya T, Takanami I, Koizumi K, Suzuki T, Kaji M, Horio H. 11C-acetate for positron emission tomography imaging of clinical stage IA lung adenocarcinoma: comparison with 18F-fluorodeoxyglucose for imaging and evaluation of tumor aggressiveness. Ann Nucl Med. 2009;23(7):609–16. https://doi.org/10.1007/s12149-009-0278-9.
Shiono S, Abiko M, Okazaki T, Chiba M, Yabuki H, Sato T. Positron emission tomography for predicting recurrence in stage I lung adenocarcinoma: standardized uptake value corrected by mean liver standardized uptake value. Eur J Cardiothorac Surg. 2011;40(5):1165–9. https://doi.org/10.1016/j.ejcts.2011.02.041.
Shiono S, Abiko M, Sato T. Limited resection for clinical stage IA non-small-cell lung cancers based on a standardized-uptake value index. Eur J Cardiothorac Surg. 2013;43(1):e7–e12. https://doi.org/10.1093/ejcts/ezs573.
Shiono S, Yanagawa N, Abiko M, Sato T. Detection of non-aggressive stage IA lung cancer using chest computed tomography and positron emission tomography/computed tomography. Interact Cardiovasc Thorac Surg. 2014;19(4):637–43. https://doi.org/10.1093/icvts/ivu188.
Sun JS, Park KJ, Sheen SS, Yoon JK, Yoon SN, Lee KB, Hwang SC. Clinical usefulness of the fluorodeoxyglucose (FDG)-PET maximal standardized uptake value (SUV) in combination with CT features for the differentiation of adenocarcinoma with a bronchioloalveolar carcinoma from other subtypes of non-small cell lung cancers. Lung Cancer. 2009;66(2):205–10. https://doi.org/10.1016/j.lungcan.2009.01.009.
Swensen SJ, Silverstein MD, Ilstrup DM, Schleck CD, Edell ES. The probability of malignancy in solitary pulmonary nodules. Application to small radiologically indeterminate nodules. Arch Intern Med. 1997;157(8):849–55.
Takenaka T, Yano T, Morodomi Y, Ito K, Miura N, Kawano D, Shoji F, Baba S, Abe K, Honda H, Maehara Y. Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography. Surg Today. 2012;42(10):934–9. https://doi.org/10.1007/s00595-012-0277-7.
Tsutani Y, Miyata Y, Nakayama H, Okumura S, Adachi S, Yoshimura M, Okada M. Solid tumor size on high-resolution computed tomography and maximum standardized uptake on positron emission tomography for new clinical T descriptors with T1 lung adenocarcinoma. Ann Oncol. 2013;24(9):2376–81. https://doi.org/10.1093/annonc/mdt230.
Uehara H, Tsutani Y, Okumura S, Nakayama H, Adachi S, Yoshimura M, Miyata Y, Okada M. Prognostic role of positron emission tomography and high-resolution computed tomography in clinical stage IA lung adenocarcinoma. Ann Thorac Surg. 2013;96(6):1958–65. https://doi.org/10.1016/j.athoracsur.2013.06.086.
Waki A, Fujibayashi Y, Yokoyama A. Recent advances in the analyses of the characteristics of tumors on FDG uptake. Nucl Med Biol. 1998;25(7):589–92.
Wang YC, Tseng HL, Lin YH, Kao CH, Huang WC, Huang TC. Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT. PLoS One. 2013;8(5):e64665. https://doi.org/10.1371/journal.pone.0064665.
Yi CA, Lee KS, Kim BT, Choi JY, Kwon OJ, Kim H, Shim YM, Chung MJ. Tissue characterization of solitary pulmonary nodule: comparative study between helical dynamic CT and integrated PET/CT. J Nucl Med. 2006;47(3):443–50.
Yonemori K, Tateishi U, Uno H, Yonemori Y, Tsuta K, Takeuchi M, Matsuno Y, Fujiwara Y, Asamura H, Kusumoto M. Development and validation of diagnostic prediction model for solitary pulmonary nodules. Respirology. 2007;12(6):856–62. https://doi.org/10.1111/j.1440-1843.2007.01158.x.
Yoshioka M, Ichiguchi O. Selection of sublobar resection for c-stage IA non-small cell lung cancer based on a combination of structural imaging by CT and functional imaging by FDG PET. Ann Thorac Cardiovasc Surg. 2009;15(2):82–8.
Zhang WD, Guan YB, Li CX, Huang XB, Zhang FJ. Pulmonary mucosa-associated lymphoid tissue lymphoma: computed tomography and (1)(8)F fluorodeoxyglucose-positron emission tomography/computed tomography imaging findings and follow-up. J Comput Assist Tomogr. 2011;35(5):608–13. https://doi.org/10.1097/RCT.0b013e318227a661.
Zhou J, Li Y, Zhang Y, Liu G, Tan H, Hu Y, Xiao J, Shi H. Solitary ground-glass opacity nodules of stage IA pulmonary adenocarcinoma: combination of 18F-FDG PET/CT and high-resolution computed tomography features to predict invasive adenocarcinoma. Oncotarget. 2017;8(14):23312–21. https://doi.org/10.18632/oncotarget.15577.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd. and People's Military Medical Press
About this chapter
Cite this chapter
Guan, Y. (2018). PET/CT for the Assessment of Pulmonary Nodules. In: Zheng, X., Li, M., Zhang, G. (eds) Early-stage Lung Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7596-4_4
Download citation
DOI: https://doi.org/10.1007/978-981-10-7596-4_4
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-7595-7
Online ISBN: 978-981-10-7596-4
eBook Packages: MedicineMedicine (R0)