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Qualitative assessment used a five-point ordinal PET-grade compared to the mediastinal blood pool, and a combined PET\/CT grade using the CT features. Semi-quantitative measures included SUVmax of the nodule, and as an uptake ratio to the mediastinal blood pool (SUR<jats:sub>BLOOD<\/jats:sub>) or liver (SUR<jats:sub>LIVER<\/jats:sub>). The endpoints were diagnosis of lung cancer via biopsy\/histology or completion of 2-year follow-up. Impact of nodule size was analysed by comparison between nodule size tertiles.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three hundred fifty-five participants completed PET\/CT and 2-year follow-up, with 59% (209\/355) malignant nodules. The AUCs of the three techniques were SUVmax 0.87 (95% CI 0.83;0.91); SUR<jats:sub>BLOOD<\/jats:sub> 0.87 (95% CI 0.83; 0.91, <jats:italic>p<\/jats:italic>\u00a0=\u20090.30 versus SUVmax); and SUR<jats:sub>LIVER<\/jats:sub> 0.87 (95% CI 0.83; 0.91, <jats:italic>p<\/jats:italic>\u00a0=\u20090.09 vs. SUVmax). The AUCs for all techniques remained stable across size tertiles (<jats:italic>p<\/jats:italic>\u00a0&gt;\u20090.1 for difference), although the optimal diagnostic threshold varied by size. For nodules &lt;\u200912\u00a0mm, an SUVmax of 1.75 or visual uptake equal to the mediastinum yielded the highest accuracy. For nodules &gt;\u200916\u00a0mm, an SUVmax \u2265\u20093.6 or visual PET uptake greater than the mediastinum was the most accurate.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this multicentre trial, SUVmax was the most accurate technique for the diagnosis of solitary pulmonary nodules. Diagnostic thresholds should be altered according to nodule size.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ISRCTN - ISRCTN30784948. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> - NCT02013063<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-020-05089-y","type":"journal-article","created":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T01:02:21Z","timestamp":1604192541000},"page":"1560-1569","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of solitary pulmonary nodule size on qualitative and quantitative assessment using 18F-fluorodeoxyglucose PET\/CT: the SPUTNIK trial"],"prefix":"10.1007","volume":"48","author":[{"name":"on behalf of the SPUtNIk investigators","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5842-842X","authenticated-orcid":false,"given":"J. 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