18F-FDG-PET/CT versus 99Tcm-MIBI-SPECT: which is better for detection of solitary pulmonary nodules ?

PURPOSE: To compare the diagnostic value of 99Tcm-MIBI- SPECT and 18F-FDG-PET/CT in differentiating benign from malignant solitary pulmonary nodules (SPNs).

METHODS: 170 SPNs were involved in this study (78 with 99Tcm-MIBI-SPECT and 92 with 18F-FDG-PET/CT). Definite diagnosis of SPNs was determined by biopsy. The diagnostic efficiency of 99Tcm-MIBI-SPECT and 18F-FDGPET/ CT in differentiating benign from malignant SPNs was analyzed and compared.

RESULTS: Seventy-eight patients with SPNs were examined with 99Tcm-MIBI-SPECT (26 with malignant SPNs and 52 with benign SPNs). The sensitivity, specificity and accuracy of 99Tcm-MIBI-SPECT were 92.31, 88.46 and 89.74%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 80 and 95.83%, respectively. Ninety-two individuals with SPNs were examined using 18F-FDG-PET/CT (58 with malignant SPNs and 34 with benign SPNs). The sensitivity, specificity and accuracy of 18F-FDG-PET/CT were 96.55, 76.47 and 89.13%, respectively. The PPV and NPV were 87.50 and 92.86%, respectively. Statistical significance was not detected in sensitivity, specificity, accuracy, PPV and NPV between these two methods.

CONCLUSION: 99Tcm-MIBI-SPECT has comparable diagnostic value with 18F-FDG-PET/CT in differentiating benign from malignant SPNs. Considering its easy availability and low-cost, 99Tcm-MIBI-SPECT could be an alternative imaging modality in differentiating benign from malignant SPNs in areas with a backward economy.