The diagnostic accuracy of integrated positron emission tomography/computed tomography in the evaluation of pulmonary mass lesions in a tuberculosis-endemic area

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dc.contributor.authorDu Toit, R.en_ZA
dc.contributor.authorShaw, J. A.en_ZA
dc.contributor.authorIrusen, E. M.en_ZA
dc.contributor.authorVon Groote-Bidlingmaier, F.en_ZA
dc.contributor.authorWarwick, J. M.en_ZA
dc.contributor.authorKoegelenberg, C. F. N.en_ZA
dc.date.accessioned2016-08-10T07:57:26Z
dc.date.available2016-08-10T07:57:26Z
dc.date.issued2015
dc.descriptionCITATION: Du Toit, R., et al. 2015. The diagnostic accuracy of integrated positron emission tomography/computed tomography in the evaluation of pulmonary mass lesions in a tuberculosis-endemic area. South African Medical Journal, 105(12):1049-1052, 10.7196/SAMJ.2015.v105i12.10300.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. Integrated positron emission tomography/computed tomography (PET-CT) is a well-validated modality for assessing pulmonary mass lesions and specifically for estimating risk of malignancy. Tuberculosis (TB) is known to cause false-positive PET-CT findings. Objective. To investigate the utility of PET-CT in the evaluation of pulmonary mass lesions and nodules in a high TB prevalence setting. Methods. All patients referred for the evaluation of a solitary pulmonary nodule or mass and who underwent PET-CT scanning over a 3-year period were included. The PET-CT findings, including maximum standardised uptake value (SUVmax), were compared with the gold standard (tissue or microbiological diagnosis). The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy for malignant disease were calculated according to the SUVmax cut-off of 2.5 and a proposed cut-off obtained from a receiver operating characteristic (ROC) curve. Results. Forty-nine patients (mean (standard deviation) age 60.1 (10.2) years; 29 males) were included, of whom 30 had malignancy. Using an SUVmax cut-off of 2.5, PET-CT had a sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for malignancy of 93.3%, 36.8%, 70.0%, 77.8% and 71.4%, respectively. After a ROC curve analysis, a suggested SUVmax cut-off of 5.0 improved the specificity to 78.9% and the diagnostic accuracy to 86.7%, with a small reduction in sensitivity to 90.0%. Conclusions. The diagnostic accuracy of PET-CT in the evaluation of pulmonary mass lesions using the conventional SUVmax cut-off of 2.5 was reduced in a TB-endemic area. An SUV cut-off of 5.0 has a higher specificity and diagnostic accuracy for malignancy, with a comparable sensitivity.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/10300/
dc.description.versionPublisher's version
dc.format.extent4 pages : illustrationsen_ZA
dc.identifier.citationDu Toit, R., et al. 2015. The diagnostic accuracy of integrated positron emission tomography/computed tomography in the evaluation of pulmonary mass lesions in a tuberculosis-endemic area. South African Medical Journal, 105(12):1049-1052, doi:10.7196/SAMJ.2015.v105i12.10300
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2015.v105i12.10300
dc.identifier.urihttp://hdl.handle.net/10019.1/99349
dc.language.isoen_ZAen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.rights.holderHealth & Medical Publishing Groupen_ZA
dc.subjectPulmonary diseasesen_ZA
dc.subjectTomography, Emissionen_ZA
dc.subjectLungs -- Diseasesen_ZA
dc.subjectTuberculosis -- Epidemiologyen_ZA
dc.titleThe diagnostic accuracy of integrated positron emission tomography/computed tomography in the evaluation of pulmonary mass lesions in a tuberculosis-endemic areaen_ZA
dc.typeArticleen_ZA
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