Evidence map›Paper›PMID 32186274›Full record

ArticleCurrent radiopharmaceuticals2020

The Multicenter Italian Trial Assesses the Performance of FDG-PET /CT Related to Pre-Test Cancer Risk in Patients with Solitary Pulmonary Nodules and Introduces a Segmental Thoracic Diagnostic Strategy.

Marco Spadafora, Laura Evangelista, Salvatore Fiordoro, Francesco Porcaro, Marilena Sicignano, Luigi Mansi

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Current radiopharmaceuticals, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Marco SpadaforaNuclear Medicine Unit, Ospedale del Mare, Naples, Italy
Laura EvangelistaNuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
Salvatore FiordoroNuclear Medicine Unit, Ospedale del Mare, Naples, Italy
Francesco PorcaroNuclear Medicine Unit, Ospedale del Mare, Naples, Italy
Marilena SicignanoNuclear Medicine Unit, Ospedale del Mare, Naples, Italy
Luigi MansiSection Health and Development, Interuniversity Research Center for Sustainability (CIRPS), Naples, Italy
Centro Interuniversitario di Ricerca Per lo Sviluppo sostenibile · ITIstituto Oncologico Veneto · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Italian Tailored Assessment of Lung Indeterminate Accidental Nodule (ITALIAN) trial is a trial drawn to determine the performance of 18F-FDG-PET/CT in patients with solitary pulmonary nodules (SPN), stratified for a different kind of risk. An additional end-point was to compare the diagnostic information and estimated dosimetry, provided by a segmental PET/CT (s-PET/CT) acquisition instead of a whole body PET/CT (wb-PET/CT), in order to evaluate if segmental thoracic PET/CT can be used in patients with SPN.

methods18F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, was retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring (4PS) system and a semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP), and between SUVmax in SPN and SUVmean in the liver (L). Histopathology and/or follow-up data were used as a standard of reference. Data obtained on the thoracic part of wb-PET/CT, defined as s - PET/CT, were compared with those deriving from wb-PET/CT.

resultsSPNs were malignant in 180 patients (36%), benign in 175 (35%), and indeterminate in 147 (29%). The 355 patients diagnosed with a definitive SPN nature (malignant or benign) were considered for the analysis of PET performance. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy were 85.6%, 85.7%, 86%, 85.2%, and 85.6%, respectively. Sensitivity and PPV were higher in intermediate and high-risk patients. 18F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT.

conclusionIn patients with SPN, the pre-test likelihood of malignancy stratification allows to better define PET clinical setting and its diagnostic power. In subjects with low-intermediate pre-test likelihood of malignancy, s-PET/CT might be planned in advance. The adoption of this segmental strategy could reduce radiation exposure, scan-time, and might allow individually targeted protocols.

Indexed as

AdultAgedFemaleFluorodeoxyglucose F18HumansItalyLung NeoplasmsMaleMiddle AgedPositron Emission Tomography Computed TomographyRadiation ExposureRadiopharmaceuticalsRetrospective StudiesRisk AssessmentSensitivity and SpecificitySolitary Pulmonary NoduleFluorodeoxyglucose F18RadiopharmaceuticalsFDGlikelihoodLung cancerPET/CTsingle pulmonary nodules

Identifiers

PMID32186274
PMCPMC8206189
OpenAlexW3012037821

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.