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To the Editor: I have several concerns about the meta-analysis by Dr Gould and colleagues¹ about positron emission tomography (PET) imaging for diagnosis of pulmonary nodules. First, the prevalence of malignancy in the articles that they included was extremely high (55%-100%; mean, 72%), suggesting that the types of lesions that have been evaluated thus far with PET imaging are those with a very high likelihood of malignancy. The accuracy of PET imaging may be far lower in a population in whom the risk of malignancy is lower. The sensitivity might be lower because of a milder spectrum of disease in patients with a lower risk of malignancy, and the specificity might be lower because of more overlapping PET findings in small lesions of varying etiologies.² Thus, the results of their review are only applicable to a population of patients with a very high prevalence of cancer. Until additional studies provide . . . [Full Text of this Article]

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RELATED ARTICLE

Accuracy of Positron Emission Tomography for Diagnosis of Pulmonary Nodules and Mass Lesions: A Meta-analysis
Michael K. Gould, Courtney C. Maclean, Ware G. Kuschner, Chara E. Rydzak, and Douglas K. Owens
JAMA. 2001;285(7):914-924.
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