481 MD and [18F]FDG-PET/CT: complementing techniques or waste of valuable resources? 12 Table 4. Test performance of MD and [18F]FDG-PET/CT in nodules with successful MD on cytology and/or histopathology (n=130) a. MD or [18F]FDG-PET/CT MD [18F]FDG-PET/CT Histopathology P value Test result Malignant or borderline Benign Malignant or borderline Benign Positive 29 32 32 59 Negative 5 64 2 37 MD on cytology and histopathology (n=130), assuming nodules under active surveillance are benign, % (95% CI) Sensitivity 85 (69-95) 94 (80-99) .45 Specificity 67 (56-76) 39 (29-49) <0.001 PPV 48 (35-61) 35 (25-46) NPV 93 (84-98) 95 (83-99) BCR 53 (44-62) 30 (22-39) MD on cytology and histopathology, surgically confirmed cases (n=107), % (95% CI) Sensitivity 85 (69-95) 94 (80-99) .45 Specificity 63 (51-74) 23 (14-35) <0.001 PPV 52 (38-65) 36 (26-47) NPV 90 (79-97) 90 (67-99) b. combined diagnostic scenario MD-/[18F]FDG- MD+/[18F]FDG+ Histopathology P value Test result Malignant or borderline Benign Malignant or borderline Benign Positive 34 66 27 25 Negative 0a 30 7 71 MD on cytology and histopathology (n=130), assuming nodules under active surveillance are benign, % (95% CI) Sensitivity 100 (90-100) 79 (62-91) n.a.b Specificity 31 (22-42) 74 (64-82) <0.001 PPV 34 (25-44) 52 (38-66) NPV 100 (88-100) 91 (82-96) BCR 23 (16-31) 60 (51-69) 95% CI, 95% confidence interval; BCR, benign call rate; [18F]FDG, 2-[18F]fluoro-2-deoxy-D-glucose; [18F]FDG-PET/ CT, positron emission tomography/computed tomography using [18F]FDG; MD-/[18F]FDG-, a negative [18F]FDGPET/CT and negative MD were considered a negative test result, all other combinations of [18F]FDG-PET/CT and MD results were considered test positive; MD+/[18F]FDG+, a positive [18F]FDG-PET/CT and positive MD were considered a positive test result, all other combinations of [18F]FDG-PET/CT and MD results were considered test negative; MD, molecular diagnostics; n, number; n.a., not applicable. NPV, negative predictive value; PPV, positive predictive value. a: considering successful MD on cytology only, one MD negative, [18F]FDG negative malignancy was reported. In this nodule, an NTRK3 fusion was found during MD on histopathology. b: not able to calculate McNemar test due to observed empty cell.
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