Background PET-CT is an important test in the management of patients with solitary pulmonary nodules (SPNs). There is a paucity of data on clinical characteristics, follow-up and outcomes of patients with PET negative nodules as compared to PET positive ones.
Objective To compare the clinical characteristics and outcomes of patients with PET positive vs PET negative SPNs managed by the Lung MDT at a large teaching hospital in North England.
Methods 144 patients (age range 32–92 years, 76 females) with SPNs measuring 8–29 mm discussed at the Lung MDT who had PET-CT scans over a 3 year period between 1st January 2007 and 31st December 2009 were identified retrospectively through the Lung Cancer database. Demographic data, nodule characteristics, MDT decisions, median time to diagnosis, and outcomes were evaluated. We tested for differences in characteristics between patients with PET positive and negative nodules using t test and Mann–Whitney U test for continuous variables, and χ2 tests or Fisher exact tests as indicated for categorical variables.
Results In comparison to PET positive nodules, PET negative ones were smaller, less likely to be spiculated, more often associated with an MDT decision to follow-up with serial CT scans, less likely to undergo surgical resection or have radical radiotherapy, had a longer median time to diagnosis, and were less likely to be malignant. The overall prevalence of malignancy in patients with PET negative nodules, however (15/41 [36.6%]) was higher than that reported in previous studies. This may be due to the higher prevalence of adenocarcinoma in our series.
Conclusions Significant differences in clinical characteristics and outcomes have been demonstrated between patients with PET positive and PET negative solitary pulmonary nodules. The overall prevalence of malignancy in patients with PET negative nodules (15/41 [36.6%]) was higher than that reported in previous studies.