J Korean Radiol Soc.  1997 Oct;37(4):641-649.

Malignant and Benign Diffuse Pleural Disease: Utility of FDG PET in Differential Diagnosis and Comparison with CT

• Lee KS
• Cheon JE
• Kim BT
• Kim Y
• Ro DW
• Kwon OJ
• Rhee CH

Abstract

PURPOSE
To assess the utility of 2-[18F] fluoro-2-deoxy-D-glucose (FDG) PET in differentiating malignant and benign diffuse pleural disease, and to compare it with CT.
MATERIALS AND METHODS
Both FDG PET and CT scans were performed in 20 consecutive patients with diffuse pleural disease (13 malignant and seven benign cases). In FDG PET, peak standardized uptake value (SUV) as well as visual assessment of abnormally increased uptake in the pleura was evaluated. The results were compared with CT findings.
RESULTS
With only visual assessment of PET images, sensitivity, specificity, and accuracy for malignancy were 92%, 43%, and 75%, respectively. With peak SUV of 4.8 or more, the corresponding figures were 100%, 57%, and 85%, respectively, and on CT interpretation, were100%, 57%, and 85%, respectively. Tuberculous empyema simulated malignant pleural disease both on FDG PET (3/6 patients with peak SUV more than 4.8) and CT (3/6 patients).
CONCLUSION
For the differentiation of malignant and benign diffuse pleural disease, FDG PET and CT are equally accurate. Combined visual and quantitative assessments of PET images enhance discriminatory ability. Tuberculous empyema simulates malignant pleural disease both on FDG PET and CT.

Keyword

Emission CT; Fluorine; Pleura, CT; Pleura, diseases; Pleura, neoplasms

MeSH Terms

Diagnosis, Differential*
Empyema, Tuberculous
Fluorine
Humans
Pleura
Pleural Diseases*
Sensitivity and Specificity
Tomography, X-Ray Computed
Fluorine