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A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose (18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study.

Title: A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose (18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study.
Authors: Proli, C
De Sousa, P
Jordan, S
Anikin, V
Devaraj, A
Love, SM
Shackcloth, M
Kostoulas, N
Papagiannopoulos, K
Haqzad, Y
Loubani, M
Sellitri, F
Granato, F
Bush, A
Marchbank, A
Iyer, S
Scarci, M
Lim, E
UK Thoracic Surgery Research Collaborative
Item Type: Journal Article
Abstract: OBJECTIVES: The aim of this study is to collate multi-institutional data to determine the value by defining the diagnostic performance of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for malignancy in patients undergoing surgery with an anterior mediastinal mass in order to ascertain the clinical utility of PET/CT to differentiate malignant from benign aetiologies in patients presenting with an anterior mediastinal mass SETTING: DECiMaL Study is a multicentre, retrospective, collaborative cohort study in seven UK surgical sites. PARTICIPANTS: Between January 2002 and June 2015, a total of 134 patients were submitted with a mean age (SD) of 55 years (16) of which 69 (51%) were men. We included all patients undergoing surgery who presented with an anterior mediastinal mass and underwent PET/CT. PET/CT was considered positive for any reported avidity as stated in the official report and the reference was the resected specimen reported by histopathology using WHO criteria. PRIMARY AND SECONDARY OUTCOME MEASURES: Sensitivity, specificity, positive and negative predicted values of [18F]-FDG PET in determining malignant aetiology for an anterior mediastinal mass. RESULTS: The sensitivity and specificity of PET/CT to correctly classify malignant disease were 83% (95% CI 74 to 89) and 58% (95% CI 37 to 78). The positive and negative predictive values were 90% (95% CI 83% to 95%) and 42% (95% CI 26% to 61%). CONCLUSIONS: The results of our study suggest reasonable sensitivity but no specificity implying that a negative PET/CT is useful to rule out the diagnosis of malignant disease whereas a positive result has no value in the discrimination between malignant and benign diseases of the anterior mediastinum.
Issue Date: 6-Feb-2018
Date of Acceptance: 14-Dec-2017
URI: http://hdl.handle.net/10044/1/60109
DOI: https://dx.doi.org/10.1136/bmjopen-2017-019471
ISSN: 2044-6055
Journal / Book Title: BMJ Open
Volume: 8
Issue: 2
Copyright Statement: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: mediastinum abnormalities
mediastinum diagnosis
mediastinum surgery
positron emission tomography computed tomography
sensitivity and specificity
UK Thoracic Surgery Research Collaborative
Publication Status: Published online
Conference Place: England
Article Number: e019471
Online Publication Date: 2018-02-06
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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