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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.

Cappabianca, Salvatore; Porto, Annamaria; Petrillo, Mario; Greco, Barbara; Reginelli, Alfonso; Ronza, Francesco; Setola, Francesca; Rossi, Giovanni; Di Matteo, Andrea; Muto, Roberto; De Rimini, Maria Luisa; Piccolo, Sergio; Catalano, Mara; Muto, Pietro; De Rosa, Nicoletta; Barra, Enrica; De Rosa, Ilaria; Antinolfi, Francesca; Antinolfi, Giuseppe; Caputi, Mario; Brunese, Luca; Grassi, Roberto; Rotondo, Antonio.
J Clin Pathol; 64(2): 114-9, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21169276

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 [(18)F]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.
Selo DaSilva