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Korean J Thorac Cardiovasc Surg. 2012 Feb;45(1):35-9. doi: 10.5090/kjtcs.2012.45.1.35. Epub 2012 Feb 7.

Comparing 18F-Fluorodeoxyglucose Positron Emission Tomography and Video-assisted Thoracoscopic Surgery in the Evaluation of Small Pulmonary Nodules in Patients with a History of Malignancy.

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1
Department of Thoracic and Cardiovascular Surgery, Sacred Heart Hospital, Hallym University College of Medicine, Korea.

Abstract

BACKGROUND:

The aims of the study were to determine the accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting pulmonary metastasis through video-assisted thoracoscopic surgery (VATS), a technique that allows the excisional biopsy of small pulmonary nodules in patients with known malignancies.

MATERIALS AND METHODS:

Between October 2007 and April 2010, 28 patients with known malignancies and small pulmonary nodules underwent VATS excisional biopsies. All patients were in follow-up for a previously treated malignancy. The malignancies included the following: colorectum (9), breast (6), head and neck (5), stomach (3), lymph (1), ovary (1), uterus (1), bladder (1), and liver (1).

RESULTS:

There were 16 men and 12 women whose mean age was 56.7 years old (range, 38 to 77 years). The sizes of the mean nodules removed were 11.3 mm (range, 7 to 21 mm). Diagnoses included metastatic (11), bronchioloalveolar carcinoma (1), primary adenocarcinoma (1), pulmonary tuberculosis (6), fibrosis (5), organizing pneumonia (3), lymphoid hyperplasia (1). Among these lesions, 46.4% were malignant.

CONCLUSION:

True positive FDG-PET was 39.2%. FDG-PET is not a sensitive test in the evaluation of patients with a history of an extrathoracic malignancy and newly diagnosed small pulmonary nodules. VATS excision allows the early diagnosis of small pulmonary nodules, with low morbidity, in patients with known malignancies.

KEYWORDS:

Biopsy; Positive emission tomography; Video-assisted thoracic surgery

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