Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: Our experience on 1,592 patients

Duilio Divisi, Mirko Barone, Luca Bertolaccini, Gaetano Rocco, Piergiorgio Solli, Roberto Crisci, Luca Ampollini, Marco Alloisio, Claudio Andreetti, Dario Amore, Guido Baietto, Alessandro Bandiera, Cristiano Benato, Diego Benetti, Mauro Benvenuti, Alessandro Bertani, Luigi Bortolotti, Edoardo Bottoni, Pierpaolo Camplese, Paolo CarbognaniGiuseppe Cardillo, Francesco Carleo, Caterina Casadio, Giorgio Cavallesco, Carlo Curcio, Andrea Denegri, Gaetano Di Rienzo, Giampiero Dolci, Andrea Droghetti, Roberto Gasparri, Marco Ghisalberti, Alessandro Gonfiotti, Francesco Guerrera, Andrea Imperatori, Maurizio Infante, Paolo Lausi, Francesco Londero, Camillo Lopez, Luca Luzzi, Paola Maineri, Pio Maniscalco, Giuseppe Marulli, Marco Monteverde, Angelo Morelli, Felice Mucilli, Pamela Natali, Giampiero Negri, Samuele Nicotra, Mario Nosotti, Reinhold Perkmann, Camilla Poggi, Francesco Puma, Mayed Refai, Alessandro Rinaldo, Giovanna Rizzardi, Lorenzo Rosso, Nicola Rotolo, Emanuele Russo, Armando Sabatini, Lorenzo Spaggiari, Alessandro Stefani, Franco Stella, Alberto Terzi, Massimo Torre, Damiano Vinci, Andrea Viti, Luca Voltolini, Francesco Zaraca

Research output: Contribution to journalArticle

Abstract

© Journal of Thoracic Disease. Background: Multislice computed tomography (MSCT) increased detection of solitary pulmonary nodules (SPNs), changing the management based on radiological and clinical factors. When 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG-PET/CT) was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5 is used frequently as a cut offfor malignancy. The purpose of this study is to evaluate SUVmax PET/CT and pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological characteristics of the lesion. Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian Registry of VATS Lobectomies. Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases (pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age, nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively). Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to the propensity to lymph node metastases.
Original languageEnglish
Pages (from-to)2551-2559
Number of pages9
JournalJournal of Thoracic Disease
Volume9
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

Keywords

  • Ground glass opacities
  • Lung adenocarcinoma
  • Lymph node metastases
  • Maximum standardized uptake value
  • Solitary pulmonary nodule (SPN)

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    Divisi, D., Barone, M., Bertolaccini, L., Rocco, G., Solli, P., Crisci, R., Ampollini, L., Alloisio, M., Andreetti, C., Amore, D., Baietto, G., Bandiera, A., Benato, C., Benetti, D., Benvenuti, M., Bertani, A., Bortolotti, L., Bottoni, E., Camplese, P., ... Zaraca, F. (2017). Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: Our experience on 1,592 patients. Journal of Thoracic Disease, 9(8), 2551-2559. https://doi.org/10.21037/jtd.2017.06.124