Evaluation of the role of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography in the differential diagnosis of pleural lesions

Ateş, M. Evaluation of the Role of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Differential Diagnosis of Pleural Lesions. Eskişehir Osmangazi University Faculty of Medicine Department of Nuclear Medicine Specialization Thesis in Medicine, Eskişehir, 2024. In this study, we aimed to retrospectively evaluate the role of F-18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in patients with pleural lesions without a known history of malignancy. 78 patients with pleural thickening were included. F-18 FDG PET-CT findings were compared with pleural histopathologic findings. The sensitivity and specificity of F-18 FDG PET-CT for the differential diagnosis of benign-malignant pleural thickening were 77.27% and 73.53%, respectively. In our study, 63 patients had an additional pleural effusion. We determined the sensitivity and specificity of PET-CT for the differentiation of malignant-malignant pleural effusion SUVmax as 59% and 58.3%, respectively. 45 of the patients had a history of asbestos exposure and no significant difference was found in the differentiation of benign-malignant pleural thickening. However, statistically significant differences were found only in cases with malignant mesothelioma in the distinction between benign pleural thickening and malignant pleural mesothelioma, pleural metastatic disease and malignant mesothelioma. Diffuse pleural thickening pattern was observed in 38 patients and focal pleural thickening pattern was observed in 40 patients. There was no significant difference between benign and malignant diseases in terms of pleural thickening pattern. There was no significant difference in the diagnosis of benign/malignant pleural disease in cigarette smoking. In conclusion, we found that F-18 FDG PET-CT was guiding in the differentiation of benign/malignant pleural thickening and the presence of a history of asbestos contact was useful in the diagnosis of malignant mesothelioma. We observed that there is a need for a larger case series of studies on the usefulness of F-18 FDG PET-CT in the differential diagnosis of pleural effusion.