FDG-PET Technology May Misdiagnose Lung Infections for Cancer

the Cancer Therapy Advisor take:

According to a new study published in The Journal of the American Medical Association, fludeoxyglucose (FDG)-positron emission tomography (PET) technology is not as accurate in diagnosing lung cancer as it is in diagnosing benign disease in areas of the lung where infections, such as histoplasmosis and tuberculosis, are common. Researchers at Vanderbilt University and Tennessee Valley Healthcare System-Veteran Affairs in Nashville, Tennessee, performed a meta-analysis that included 70 studies over a 14-year period.

The researchers found that FDG-PET technology was associated with more false-positive results, which means decreased specificity for diagnosing lung cancer in areas of the globe where infectious lung diseases are observed more often than in the general population. Fungal infections like blastomycosis, coccidioidomycosis, and histoplasmosis, which are the most prevalent lung infections in the United States, can cause granulomas that may be mistaken for malignant lesions by FDG-PET technology.

The researchers suggest that in areas where these fungal infections are more common, patients found to have inflamed nodules may be referred for biopsies or lung surgeries that are unnecessary. Furthermore, the researchers recommend limiting FDG-PET use to regions where lung infections are not common unless an institution has verified expertise in interpreting FDG-PET.