Alves, L.

Bassett, Paul

Bille, Andrea

Breen, Ronan

Chalampalakis, Z.

Chicklore, S.

Cook, G.j.

Martins, N.

Murphy, D.j.

Nair, A.

Royle, L.

Subesinghe, M.

English

Purpose: British Thoracic Society (BTS) guidelines advocate using FDG PET-CT with the Herder model to estimate malignancy risk in solitary pulmonary nodules (SPNs). Qualitative and semi-quantitative assessment of SPN uptake is based upon analysis of Ordered Subset Expected Maximisation (OSEM) PET images. Our aim was to assess the effect of a Bayesian Penalised Likelihood (BPL) PET reconstruction on the assessment of SPN FDG uptake and estimation of malignancy risk (Herder score). Methods: Subjects with SPNs who underwent FDG PET-CT between 2014–2017, with histological confirmation of malignancy or histological/imaging follow-up confirmation of benignity were included. Two blinded readers independently classified SPN uptake on both OSEM and BPL (BTS score; 1 = none; 2 = ≤ mediastinal blood pool (MBP); 3 = &gt;MBP but ≤ 2x liver; 4 = &gt;2x liver), with resultant calculation of the Herder score (%) for both reconstructions. Results: 97 subjects with 75 (77%) malignant SPNs were included. BPL increased the BTS score in 25 (26%) SPNs; 9 SPNs (7 malignant) increased from BTS score 2 to 3, 16 (13 malignant) from BTS score 3 to 4, with a mean Herder score increase of 18 ± 22%. The mean Herder score for all SPNs with BPL was higher than OSEM (73 ± 29 vs 68 ± 32%, p = 0.001). There was no difference in Herder model diagnostic performance between BPL and OSEM, with similar areas under the curve (0.84 vs 0.83, p = 0.39). Conclusion: BPL increases the Herder score in 26% of SPNs compared to OSEM but does not alter the diagnostic performance of the Herder model.</p

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The effect of a novel Bayesian penalised likelihood PET reconstruction algorithm on the assessment of malignancy risk in solitary pulmonary nodules according to the British Thoracic Society guidelines

https://kclpure.kcl.ac.uk/ws/files/112093533/The_effect_of_a_MURPHY_Published_Online_10_June_2019_GREEN_AAM.pdf

The effect of a novel Bayesian penalised likelihood PET reconstruction algorithm on the assessment of malignancy risk in solitary pulmonary nodules according to the British Thoracic Society guidelines

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