Open Access Research Article

Analysis of false positivity of FDG PET-CT: Thoracic Surgery Experience

Fazli Yanik*

Trakya University School of Medicine, Thoracic Surgery Department, Edirne, Turkey

Corresponding Author

Received Date: February 24, 2019;  Published Date: March 06, 2019


Introduction: PET/CT (Positron Emission Tomography) is one of the current methods for tumor detection. PET/CT provides a very effective biological point of view on oncologic imaging. There are hundreds of studies that demonstrate the efficacy of PET/ CT in terms of both diagnosis and treatment planning for thoracic lesions. The aim of this study was to analysis surgically verified the false positivity of FDG PET-CT in our clinic between February 2014 and February 2019.

Material and Methods: Fifty-six patients with PET-CT positive results and preoperatively suspicious diagnosed as malignancy, but whose final histopathological results were reported as benign diseases were included in the study. Patients who had PET/CT due to intrathoracic mass and whose histopathological validation could be reached were included in the study.

Result: Twenty of the patients (34%) were female and 36 of them (66%) male with the mean age 54,7±4,03 (range 30-69) years. Wedge resection by posterolateral thoracotomy in 32 (57%) patients, intraparenchymal punch biopsy by lateral thoracotomy in 10 (18%) patients, wedge resection by VATS in 8 (14%) patients, and intraparenchymal punch biopsy with VATS in 6 (11%) patients was performed to reach a definitive diagnosis. No intraoperative or postoperative complications were observed in any patient. Most frequently detected false positive result was due to tuberculosis in 21 patients and the mean SUVmax value was 5,1 (range 2,5-14). Other false positive results were sarcoidosis, inflammation (pneumonia, abscess, BOOP etc.), intrapanimal lymph node, ruptured hydatid cyst, hamartoma and lastly granulomatosis with polyangiitis by frequency order. When the PET/CT values of all patients were examined, the mean SUV max value in all of the false positive cases was measured as 8,4 (0.6-26).

Conclusion: The use of PET/CT for thoracic lesions has been increasing over the last years. In addition, the detection of false positive lesions and over diagnostics are also increasing. Keep in mind the possible false positives of PET/CT and the results should be evaluated by clinicians according to the demographic, socio-cultural characteristics of countries, and the characteristics of endemic diseases in countries.

Keywords: FDG; PET-CT; False positity; Thoracic surgery

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