Hyperattenuating adrenal lesions in lung cancer: biphasic CT with unenhanced and 1-min enhanced images reliably predicts benign lesions

The solitary pulmonary nodule is a common finding that is observed in more than 150,000 persons each year in the United States. Factors influencing probability of malignancy are discussed, including age and environmental factors. Investigative studies are described. Imaging includes chest radiography, computed tomography, and positron emission tomography. Biopsy can be excisional or performed via transthoracic needle or bronchoscopy. The differential diagnosis is broad and can include malignant or benign lesions. Malignant lesions include nonsmall cell lung cancer, small cell lung cancer, pulmonary neuroendocrine tumors, and metastatic malignancies. Benign lesions can include pulmonary hamartoma or inflammatory or infectious nodules. Few, if any, randomized controlled trials exist to direct management. Most clinicians rely on a combination of single-institution studies, a few prospective trials, and clinical acumen to assess a given patient's risk profile to inform decisions on invasive and noninvasive testing. In this review, the tables describe the differential diagnosis of a solitary pulmonary nodule, factors affecting malignant probability of a solitary pulmonary nodule, and the initial assessment of probability of cancer in a solitary pulmonary nodule. This review contains 5 figures, 4 tables, and 73 references. Key Words: bronchoscopy, compute tomography, lung cancer, nodule, positron emission tomography, solitary

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Somatostatin receptor scintigraphy with 99mTc-depreotide (neospect) in discriminating between malignant and benign lesions in the diagnosis of lung cancer: a pilot study

Acta Radiologica ◽

10.1080/02841850410001394 ◽

2004 ◽

Vol 45 (8) ◽

pp. 833-839 ◽

Cited By ~ 11

Author(s):

M. Bååth ◽

K. G. Kölbeck ◽

R. Danielsson

Keyword(s):

Lung Cancer ◽

Pilot Study ◽

Somatostatin Receptor ◽

Somatostatin Receptor Scintigraphy ◽

Benign Lesions ◽

Receptor Scintigraphy ◽

Diagnosis Of Lung Cancer

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Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions

Annals of Nuclear Medicine ◽

10.1007/s12149-009-0260-6 ◽

2009 ◽

Vol 23 (5) ◽

pp. 427-435 ◽

Cited By ~ 30

Author(s):

Kazuyoshi Suga ◽

Yasuhiko Kawakami ◽

Atsuto Hiyama ◽

Kazurou Sugi ◽

Kazutomo Okabe ◽

...

Keyword(s):

Lung Cancer ◽

Fdg Pet ◽

Small Cell ◽

Benign Lesions ◽

Small Cell Lung ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan ◽

Time Point

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Impact of 18F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

Radiologia Brasileira ◽

10.1590/s0100-39842011000500004 ◽

2011 ◽

Vol 44 (5) ◽

pp. 279-282 ◽

Cited By ~ 4

Author(s):

Kamlesh Mohan ◽

James McShane ◽

Richard Page ◽

Klaus Irion ◽

Martin J. Ledson ◽

...

Keyword(s):

Lung Cancer ◽

Surgical Resection ◽

False Positive ◽

Fdg Pet ◽

Pet Scan ◽

Benign Lesions ◽

Group I ◽

Pet Scanning ◽

Fdg Pet Scan ◽

Group Ii

OBJECTIVE: The main utility of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) lies in the staging of lung cancer. However, it can also be used to differentiate indeterminate pulmonary lesions, but its impact on the resection of benign lesions at surgery is unknown. The aim of this study was to compare the prevalence of benign lesions at thoracotomy carried out for suspected lung cancer, before and after the introduction of PET scanning in a large thoracic surgical centre. MATERIALS AND METHODS: We reviewed our prospectively recorded surgical database for all consecutive patients undergoing thoracotomy for suspected or proven lung cancer and compared the prevalence of benign lesions in 2 consecutive 2-year groups, before (group I) and after (group II) the introduction of FDG-PET scan respectively. RESULTS: Surgical resection was performed on 1233 patients during the study period. The prevalence of benign lesions at surgery in groups I and II was similar (44/626 and 41/607, both 7%), and also in group II between those who underwent FDG-PET scan and the remainder (21/301 and 20/306 respectively, both 7%). In group II, of the 21 patients with benign lesions, who underwent FDG-PET, 19 had a false positive scan (mean standardised uptake value 5.3 [range 2.6-12.7]). Of these, 13 and 4 patients respectively had non-diagnostic bronchoscopy and percutaneous transthoracic lung biopsy pre thoracotomy. There was no difference in the proportion of different benign lesions resected between group I and those with FDG-PET in group II. CONCLUSION: The introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection.

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