Division of Nuclear Medicine, Department of Radiology, School of Medicine, St. Louis University, St. Louis, MO 63110, USA.
Clin Nucl Med. 2009 Dec;34(12):886-90. doi: 10.1097/RLU.0b013e3181bece11.
The current study characterized pleural changes induced by talc pleurodesis (TP), based on serial positron emission tomography/computer-tomography (PET/CT) with F-18 fluorodeoxyglucose (FDG).
A total of 8 cancer patients who had both TP and PET/CT and no evidence of active pleural involvement after TP were retrospectively evaluated. Maximum standard uptake values, maximum Hounsfield units (HU), and thickness were followed over time.
The 8 patients had 25 PET/CT scans performed in an average of 22 months after TP. An increased FDG uptake was associated with an increase in pleural thickness within 5 months after TP, and both parameters showed statistical significance as compared with findings before TP. After 5 months of TP, the standard uptake value appeared to persist or increase further, and the pleural thickening stabilized. The formation of calcification was a slow process and might lag behind the changes in FDG metabolism and pleural thickness. The HU did not change significantly once pleural calcification had been formed.
Knowledge of aforementioned pleural changes may help differentiate TP induced pleural inflammation from pleural malignancy and to avoid false-positive interpretation of FDG PET/CT exams.
本研究基于氟-18 氟代脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT），对滑石粉胸膜固定术（TP）引起的胸膜变化进行了特征描述。
回顾性分析了 8 例既接受 TP 又接受 PET/CT 检查且 TP 后无活动性胸膜受累证据的癌症患者。随访时间内测量最大标准摄取值、最大亨氏单位（HU）和厚度。
8 例患者在 TP 后平均 22 个月内共进行了 25 次 PET/CT 扫描。与 TP 前相比，TP 后 5 个月内 FDG 摄取增加与胸膜厚度增加相关，这两个参数均具有统计学意义。TP 后 5 个月，标准摄取值似乎持续增加或进一步增加，胸膜增厚稳定。钙化的形成是一个缓慢的过程，可能落后于 FDG 代谢和胸膜厚度的变化。一旦形成胸膜钙化，HU 变化不明显。
了解上述胸膜变化有助于鉴别 TP 引起的胸膜炎症与胸膜恶性肿瘤，并避免 FDG PET/CT 检查的假阳性解读。
