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Clinical Investigations: TUBERCULOSIS |

Uptake Rates of 18F-Fluorodeoxyglucose and 11C-Choline in Lung Cancer and Pulmonary Tuberculosis*: A Positron Emission Tomography Study

Toshihiko Hara; Noboru Kosaka; Tsuneo Suzuki; Koichiro Kudo; Hitoshi Niino
Author and Funding Information

*From the Departments of Radiology (Drs. Hara and Kosaka), Internal Medicine (Drs. Suzuki and Kudo), and Pathology (Dr. Niino), International Medical Center of Japan, Tokyo, Japan.

Correspondence to: Toshihiko Hara, MD, PhD, Department of Radiology, Indiana University School of Medicine, 1345 West 16th St, L-3, Room 212, Indianapolis, IN 46202-2111; e-mail: toshara@iupui.edu



Chest. 2003;124(3):893-901. doi:10.1378/chest.124.3.893
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Study objective: The purpose of this study was to examine the uptake rates of 18F-fluorodeoxyglucose (FDG) and 11C-choline in patients with lung cancer, pulmonary tuberculosis, and atypical mycobacterial infection of the lung by positron emission tomography (PET) scanning with relation to their tumor size.

Design: Ninety-seven patients with untreated lung cancer, 14 patients with untreated pulmonary tuberculosis, and 5 patients with untreated atypical mycobacterial infection were examined. The diagnosis of lung cancer was confirmed pathologically after biopsy and surgery. The diagnosis of tuberculosis and atypical mycobacterial infection was confirmed by bacterial culture. The uptake rates of FDG and 11C-choline were presented quantitatively as the standardized uptake value (SUV).

Setting: International Medical Center of Japan.

Results: In lung cancer patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of 11C-choline was almost constant at around 3.5 for every tumor size. In tuberculosis patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of 11C-choline was almost constant at around 2 for every tumor size. In atypical mycobacterial infection patients, the SUV of FDG and the SUV of 11C-choline were equally low at around ≤ 2.

Conclusion: The differences in the SUVs of FDG and 11C-choline in patients with lung cancer, tuberculosis, and atypical mycobacterial infection for the same tumor size (tumor size, > 1.5 cm) were distinct. In lung cancer patients, the SUVs of both FDG and 11C-choline were high. In tuberculosis patients, the SUV of FDG was high, but the SUV of 11C-choline was low. In atypical mycobacterial infection patients, the SUVs of both FDG and 11C-choline were low. It may be possible to apply this principle to make a presumptive diagnosis of a solitary pulmonary nodule if it is too small to make a definitive diagnosis pathologically and bacteriologically.

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