@article{oai:repo.qst.go.jp:00046340,
 author = {Kubota, Kazuo and Murakami, Koji and Inoue, Tomio and Saga, Tsuneo and Shiomi, Susumu and 村上 康二 and 井上 登美夫 and 佐賀 恒夫},
 issue = {10},
 journal = {Annals of Nuclear Medicine},
 month = {Sep},
 note = {Objective This study was a controlled multicenter clinical
study on patients with peripheral lung nodules to verify the
improvement in the diagnostic ability of FDG-PET when
used in combination with thin-section CT (TS-CT).
Methods Patients with peripheral lung nodules (long
maximal diameter: 10–30 mm) detected using CT were
examined using TS-CT and FDG-PET for the differential
diagnosis of benign or malignant lesions. The primary
endpoint was the specificity of the results using a combination
of TS-CT and FDG-PET, compared with the results
for TS-CT alone. Images were interpreted by investigators
at each institution. Blind readings were also performed by
an independent image interpretation committee. The gold
standard was a pathological diagnosis determined using a
surgical or biopsy specimen obtained after PET; and the
patients in whom a pathological diagnosis could not be
obtained were diagnosed based on a follow-up TS-CT
performed more than 6 months later. Adverse reactions to
FDG were also evaluated.
Results The blind reading results for 82 lesions in 81
subjects eligible for analysis among the 90 subjects included
in the study showed a specificity of 91.2% (31/34)
(95% CI: 76.3–98.1) for TS-CT ? PET, compared with a
specificity of 67.6% (23/34) (95% CI: 49.5–82.6) for TSCT
alone. The specificity was significantly improved by the
addition of the PET findings (p.05). The sensitivity
improved from 89.6% (43/48) for TS-CT to 91.7% (44/48)
for TS-CT ? PET; the addition of PET increased the level
of confidence in the diagnosis, but the difference was not
significant. The results reported by the institutional investigators
were not significantly different. No serious adverse
reactions occurred, although two of the 90 subjects
exhibited mild adverse reactions.
Conclusions The addition of FDG-PET to TS-CT for the
differential diagnosis of benign or malignant peripheral
lung nodules resulted in a significant improvement in
specificity. Although a definitive diagnosis of lung nodules
requires a histopathological or cytological examination,
when combined with TS-CT, FDG-PET can provide
additional diagnostic information and improve the
specificity.},
 pages = {787--795},
 title = {Additional effects of FDG-PET to thin-section CT for the differential diagnosis of lung nodules: a Japanese multicenter clinical study},
 volume = {25},
 year = {2011}
}