PET tops CT for malignant lung nodule characterization

A large multicenter trial rates FDG-PET as more reliable than CT for the detection of malignant solitary pulmonary nodules. Findings suggest, however, that a combined, rather than single, modality approach may lead to earlier treatment and help avoid invasive procedures.

From January 1999 to June 2001, lead investigator Dr. James W. Fletcher and colleagues at 10 VA hospitals in seven states prospectively enrolled 344 patients with a recent SPN diagnosis who had not yet been treated for the condition. All patients underwent FDG-PET and CT scanning. Researchers correlated imaging results with biopsies from 184 of these patients and two-year follow-up data from 160 of them. The investigators found that PET results interpreted as definitely malignant were 10 times more likely to be true positives than CT's. However, both PET and CT could predict benign diagnoses. They published results in the Journal of Nuclear Medicine (2008;49:179-185).