Diagnostic success of transthoracic needle biopsy and PET‐CT for 1 to 2 cm solid indeterminate pulmonary nodules

摘要

Abstract Objectives Among the nodule types, the most controversial group are indeterminate solid nodules from 1 to 2 cm in size with the first choice being transthoracic needle biopsy (TTNB) or positron emission tomography (PET‐CT) or both methods together. However, no single diagnostic algorithm could be applied to all cases. This research discusses the diagnostic success of PET‐CT and TTNB. Materials and Methods 407 Patients who referred to our hospital for any reason, with solid nodules with the size from 1 to 2 cmincidentally identified on the thoracic CT tests were investigated. Among the patients who underwent biopsy, 312 cases had PET‐CT, and maximum SUV (SUVmax) values of the nodules were examined. Values of?≥2.5 were accepted as hypermetabolic. Results The mean age of the patients was 61?±?10.8?years. 84 patients were female (20.6%) and 323 were male (79.4%). For TTNB; sensitivity, specificity and accuracy rates of all cases, who were correctly diagnosed, were 76.9%, 83.3% and 78.9%, respectively ( P ??.001). The 2.5 SUVmax cutoff value had sensitivity of 91%, specificity of 35.6%, accuracy of 75% ( P ?=?.034). The cutoff value of 49?years of age, nodule size of 16.4?mm, gender and 2.5 SUVmax value had high accuracy for benign‐malignant differentiation. No statistically significant difference was found in the upper lobe localization of nodule. Conclusion A positive result from TTNB is a reliable finding; however, a negative result is not definitive. The high negative predictive value of PET‐CT is effective in preventing the unnecessary biopsies and surgical procedures.