Background: The diagnosis of malignancy may be difficult to establish in solitary pulmonary nodules (SPNs). Objectives: It was the aim of this study to assess diagnostic performances of technetium-99m (99mTc)-depreotide in differentiating benign from malignant SPNs and compare its diagnostic accuracy with fluor-18-fluoro-deoxyglucose positron emission tomography (FDG-PET) in a subgroup of patients. Methods: One hundred and eighteen patients presenting with an SPN ≤3 cm suspected of malignancy on CT were included in a prospective, open-label, European multicentre trial. Single photon emission computed tomography (SPECT) images were acquired 1.1–4.5 h after injection of 459–770 MBq of 99mTc-depreotide. A subset of 29 patients also underwent FDG-PET imaging. Images were interpreted blindly and correlated with histopathology. Results:99mTc-depreotide was positive in 65 of 73 patients with a malignant lesion and negative in 30 of 45 patients with a benign lesion, resulting in a sensitivity, specificity and diagnostic accuracy of 89, 67 and 81%, respectively. In 40 patients with SPN ≤1.5 cm, diagnostic accuracy was 88, sensitivity 75 and specificity 96%. In the subset of 29 patients who underwent both 99mTc-depreotide SPECT and FDG-PET imaging, sensitivity, specificity and diagnostic accuracy were identical for both modalities, i.e. 90, 67 and 83%, respectively. Conclusions: The diagnostic accuracy of 99mTc-depreotide SPECT is good and comparable with FDG-PET imaging in SPN of indeterminate origin.

Keywords:
Solitary pulmonary nodule, 99mTc-depreotide, Lung cancer
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© 2006 S. Karger AG, Basel
2006
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