Preliminary study on the correlation between grading and histology of solitary pulmonary nodules and contrast enhancement and [18F]fluorodeoxyglucose standardised uptake value after evaluation by dynamic multiphase CT and PET/CT
- Salvatore Cappabianca1,
- Annamaria Porto1,
- Mario Petrillo1,
- Barbara Greco1,
- Alfonso Reginelli1,
- Francesco Ronza1,
- Francesca Setola1,
- Giovanni Rossi2,
- Andrea Di Matteo2,
- Roberto Muto2,
- Maria Luisa De Rimini3,
- Sergio Piccolo3,
- Mara Catalano3,
- Pietro Muto3,
- Nicoletta De Rosa4,
- Enrica Barra4,
- Ilaria De Rosa4,
- Francesca Antinolfi4,
- Giuseppe Antinolfi4,
- Mario Caputi5,
- Luca Brunese6,
- Roberto Grassi1,
- Antonio Rotondo1
- 1Department of Clinical Internal Medicine ‘F Magrassi–L Lanzara’, Science Section of Radiology, Second University of Studies of Naples, Naples, Italy
- 2Department of Radiology, AORN Monaldi, Naples, Italy
- 3Department of Nuclear Medicine, AORN Monaldi, Naples, Italy
- 4Department of Anatomy and Pathological Histology, AORN Monaldi, Naples, Italy
- 5Department of Pathophysiology Cardiopulmonary Rehabilitation, AORN Monaldi, Naples, Italy
- 6Department of Health Sciences, Università del Molise, Contrada Tappino, Campobasso, Italy
- Correspondence to Professor Salvatore Cappabianca, Department of Internal Medicine ‘F Magrassi–L Lanzara’, Science Section of Radiology, Seconda Università degli Studi di Napoli, Piazza Miraglia 2, 80121 Naples, Italy;
- Accepted 7 October 2010
- Published Online First 17 December 2010
Aim To evaluate whether the histology and grading of solitary pulmonary nodules (SPNs) correlated with the results of dynamic multiphase multidetector CT (MDCT) and the [18F]fluorodeoxyglucose standardised uptake value (SUV) in 30 patients.
Methods Chest x-rays of 270 patients with incidentally detected SPNs were retrospectively evaluated. Thirty patients with histologically proven SPNs were enrolled. On MDCT and positron emission tomography (PET)/CT images, two experts measured the density of nodules in all perfusion phases and the SUV. Net enhancement (NE) was calculated by subtracting peak pre-contrast density from peak post-contrast density. The Pearson test was used to correlate nodule NE, SUV, grading, histology and diameter.
Results Of the 30 malignant SPNs, six were classified as G1 (median NE, 31.5 Hounsfield units (HU); median SUV, 4.8 units), 15 were classified as G2 (median NE, 49 HU; median SUV, 6 units), and nine were classified as G3 (median NE, 32 HU; median SUV, 4.5 units). A highly negative correlation was found in G3 SPNs between NE and the corresponding diameters (r=−0.834; p=0.00524). NE increased with the increase in diameter (r=0.982; p=0.284). SUV increased as the SPN diameter increased (r=0.789; p=0.421). NE and SUV were higher in G2 than G1 SPNs, and lower in G2 than G3 SPNs (r=0.97; p=0.137).
Conclusions The significant correlation in dedifferentiated (G3) SPNs between NE and diameter (r=−0.834; p=0.00524) supports the theory that stroma and neoangiogenesis are fundamental in SPN growth. The highly negative correlation between NE and diameter demonstrates a net decrease in perfusion despite an increase in dimension. The multidisciplinary approach used herein may result in a more precise prognosis and consequently a better therapeutic outcome, particularly in patients with undifferentiated lung cancer.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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