Solitary pulmonary nodule other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

PET Scan

Solitary pulmonary nodule - Hypermetabolic focus in the left upper lobe

• After a 4 hour fast, the patient was injected with 10 mCi of 18-FDG IV and after allowing one hour for localization, transmission and emission PET data were acquired.
• A hypermetabolic focus can be seen in the left upper lobe corresponding to the chest x-ray abnormality. No other abnormalities are seen. The hypermetabolic nodule suggests a malignant process without metastasis. Lesions with only slight tracer uptake can be evaluated quantitatively for significance.
• A significant uptake value (SUV) can be calculated by dividing the mean activity in the suspicious area (mCi/ml) by the injected dose (mCi) per kilograms of body weight. Using a (SUV) of 2.5 or greater to define a malignancy, the sensitivity and specificity of 18-FDG-PET for detecting cancer in solitary pulmonary nodules greater than 1.2 cm approaches 90% with a nearly 100% specificity (1). *False positives have included infectious etiologies, and sarcoid.