脾脏实性肿块：18F-FDG PET/CT评估

Solid splenic masses: evaluation with 18F-FDG PET/CT.

作者信息

Metser Ur, Miller Elka, Kessler Ada, Lerman Hedva, Lievshitz Gennady, Oren Ran, Even-Sapir Einat

机构信息

Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, 6 Weizman St., Tel-Aviv, 64239 Israel.

出版信息

J Nucl Med. 2005 Jan;46(1):52-9.

PMID:15632034

Abstract

UNLABELLED

Our objective was to assess the role of (18)F-FDG PET/CT in the evaluation of solid splenic masses in patients with a known malignancy and in incidentally found lesions in patients without known malignancy.

METHODS

Two groups of patients were assessed: (a) 68 patients with known malignancy and a focal lesion on PET or a solid mass on CT portions of the PET/CT study; and (b) 20 patients with solid splenic masses on conventional imaging without known malignancy. The standard of reference was histology (n = 16) or imaging and clinical follow-up (n = 72). The lesion size, the presence of a single versus multiple splenic lesions, and the intensity of (18)F-FDG uptake expressed as a standardized uptake value (SUV) were recorded. The ratio of the SUV in the splenic lesion to the background normal splenic uptake was also calculated. These parameters were compared between benign and malignant lesions within each of the 2 groups of patients and between the 2 groups.

RESULTS

The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of (18)F-FDG PET/CT in differentiating benign from malignant solid splenic lesions in patients with and without malignant disease were 100%, 100%, 100%, and 100% versus 100%, 83%, 80%, and 100%, respectively. In patients with known malignant disease, an SUV threshold of 2.3 correctly differentiated benign from malignant lesions with the sensitivity, specificity, PPV, and NPV of 100%, 100%, 100%, and 100%, respectively. In patients without known malignant disease, false-positive results were due to granulomatous diseases (n = 2).

CONCLUSION

(18)F-FDG PET can reliably discriminate between benign and malignant solid splenic masses in patients with known (18)F-FDG-avid malignancy. It also appears to have a high NPV in patients with solid splenic masses, without known malignant disease. (18)F-FDG-avid splenic masses in patients without a known malignancy should be further evaluated as, in our series, 80% of them were malignant.

摘要

未标注

我们的目的是评估¹⁸F - FDG PET/CT在已知恶性肿瘤患者中实性脾肿块评估以及在无已知恶性肿瘤患者偶然发现病变评估中的作用。

方法

评估两组患者：(a) 68例已知恶性肿瘤且PET检查有局灶性病变或PET/CT检查CT部分有实性肿块的患者；(b) 20例传统影像检查发现实性脾肿块但无已知恶性肿瘤的患者。参考标准为组织学（n = 16）或影像及临床随访（n = 72）。记录病变大小、脾内单发与多发病变情况以及以标准化摄取值（SUV）表示的¹⁸F - FDG摄取强度。还计算脾病变SUV与背景正常脾摄取的比值。比较两组患者中每组良性与恶性病变之间以及两组之间的这些参数。

结果

¹⁸F - FDG PET/CT在有和无恶性疾病患者中鉴别良性与恶性实性脾病变的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为100%、100%、100%和100%，而在无已知恶性疾病患者中分别为100%、83%、80%和100%。在已知恶性疾病患者中，SUV阈值为2.3可正确区分良性与恶性病变，敏感性、特异性、PPV和NPV分别为100%、100%、100%和100%。在无已知恶性疾病患者中，假阳性结果归因于肉芽肿性疾病（n = 2）。