FDG-PET imaging and the diagnosis of non-small cell lung cancer in a region of high histoplasmosis prevalence

Lung Cancer. 2002 Jun;36(3):297-301. doi: 10.1016/s0169-5002(02)00023-5.


Study objective: Determine the sensitivity and specificity of [F-18]-fluorine-2-deoxy-D-glucose positron emission tomography (FDG-PET) in differentiating non-small cell lung cancer (NSCLC) from benign solitary pulmonary nodules (SPNs) in a region with a high endemic rate of histoplamosis.

Design: Prospective, clinical study.

Setting: University, tertiary referral hospital in the upper Mississippi River valley.

Patients: Ninety patients with SPNs.

Interventions: Independent interpretation of FDG-PET imaging, computed tomography and pathologic evaluation of the SPNs.

Measurements and results: To detect malignant SPNs, FDG-PET imaging had a sensitivity of 93%, a specificity of 40%, a positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 55%.

Conclusions: In a region with a high prevalence of pulmonary fungal infection, FDG-PET is sensitive but has a low specificity and NPV for identifying NSCLC. In our study cohort, FDG-PET does not appear to reduce the need for SPN biopsies.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Histoplasmosis / diagnostic imaging
  • Histoplasmosis / epidemiology
  • Humans
  • Iowa / epidemiology
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*
  • Tomography, X-Ray Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18