Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of solitary pulmonary nodule: a scoping review

Background: The role of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) in the surgical approach of solitary pulmonary nodule (SPN) is still debated, as the increased metabolic avidity of the lesion was not a sure sign of malignancy. The purpose of this study was to evaluate the effectiveness of18 F-FDG-PET/CT in the characterization of SPN based on the analysis of the most recent data in the literature. Methods: We analyzed systematically the studies in 5 years (from 2016 to 2020), considering sensitivity, specificity and diagnostic accuracy. The reference values have established, beyond which the data have deemed significant. Results:18F-FDG-PET/CT showed sensitivity, specificity and diagnostic accuracy values between 37.8% and 100%, 23.4% and 98.3%, 79.2% and 84.0% respectively. The data collected were very heterogeneous but, analyzing the value curves and the linear curves it was evident that the specificity levels of PET/CT decreased with the increase in the number of patients enrolled in the different experiences. Conclusions:18 F-FDG-PET/CT represents a valid tool in the diagnostic path of SPN but it cannot replace biopsy in the characterization of lesion until a direct correlation between standardized uptake value and the degree of malignancy is demonstrated.