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Fırat Tıp Dergisi
2023, Cilt 28, Sayı 1, Sayfa(lar) 034-039
[ Turkish ] [ Tam Metin ] [ PDF ]
Comparative Evaluation of PET-CT with Mediastinoscopy or Thoracotomy in Lung Masses and Pleural Malignancies
Murat KILIÇ1, Akın Eraslan BALCI2, Tansel Ansal BALCI3
1Fethi Sekin Şehir Hastanesi, Göğüs Cerrahisi Kliniği, Elazığ, Türkiye
2Fırat üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Elazığ, Türkiye
3Fırat üniversitesi Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, Elazığ, Türkiye

Objective: To compare positron emission tomography (PET/CT) results and the pathological results of tissue samples obtained by mediastinoscopy or thoracotomy in patients with lung mass or pleural thickening and to discuss the study results in the light of the literature.

Material and Method: The study included 49 patients who were operated on due to mediastinal mass, lung mass, pulmonary nodule, or pleural thickening. Preoperative PET/CT results of the patients were compared with the pathological results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT in detecting pulmonary, mediastinal, and pleural malignancies were compared with reference to the PET/CT SUVmax cutoff value of 2.5 versus 4.8. The diagnostic value of PET/CT in distinguishing benign and malignant lesions and the correlation between the two SUVmax cutoff values and pathological results were evaluated.

Results: The lesions were reported as malignant in 33 (67.3%) and as benign in 16 (32.7%) patients in pathological examination. The lesions were located in the right hemithorax in 24 (49%), in the left hemithorax in 17 (35%), bilaterally in 2 (4%), and in the mediastinum in 6 (12%) patients. In PET-CT examination, 45 (91.8%) patients had a SUVmax >2.5, among whom 31 patients were detected with a malignant lesion and 14 patients were detected with a benign lesion in histopathological examination. At a cutoff value of 4.8, however, 35 (71.4%) patients had a SUVmax >4.8, among whom 29 patients were detected with a malignant lesion and 6 patients were detected with a benign lesion.

Conclusion: When the basal SUV-max value of PET-CT, which is used in order to detect thoracic malignancies, was accepted as 2.5; In some cases, it was found to be insufficient to detect malignant pathologies. However, when the basal SUV-max value was accepted as 4.8, PET-CT was found to be more effective in detecting malignant pathologies.


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