From the *Departments of Nuclear Medicine and †Pathology, Changhai Hospital, Second Military Medical University, Shanghai; ‡Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai; and §Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Clin Nucl Med. 2014 Feb;39(2):113-21. doi: 10.1097/RLU.0b013e3182952caa.
The aim of this study was to evaluate retrospectively F-FDG PET/CT findings of inflammatory myofibroblastic tumor (IMT) and their correlation with the pathologic findings.
FDG PET/CT findings were reviewed in 5 patients with IMT and 1 patient with spindle cell sarcoma transformed from IMT. PET/CT scans were performed in all 6 patients before surgery. Follow-up FDG PET/CT scan was performed in 1 patient. The location, size, maximal standardized uptake value (SUVmax), and pathologic findings of the tumors were reviewed. The correlation between the FDG uptake and pathologic findings were analyzed.
A total of 10 lesions were detected in all 6 patients. The tumor locations were liver (n = 3), retroperitoneum (n = 2), spleen (n = 1), lung (n = 1), and bone (n = 3). Seven IMTs and 1 spindle cell sarcoma transformed from IMT were confirmed by pathology. The mean SUVmax of the pathologically proven tumors was 10.9 ± 5.5, with a high variability of SUVmax among tumors ranging from 3.3 to 20.8. The tumors (n = 7) with high cellularity had stronger FDG uptake, while the tumors (n = 1) with low cellularity had relatively low FDG uptake. The tumors with nuclear atypia and relatively high proliferative index had very strong FDG uptake, while those with low proliferative index or negative Ki-67 staining had relatively lower FDG uptake. One small tumor with abundant plasma cells showed high FDG uptake, while 1 large tumor with focal inflammatory cell infiltrate showed lower FDG uptake. One patient developed local recurrences and distant metastases revealed by the second FDG PET/CT scan 7 months after resection.
FDG uptake in IMTs varied from low to high FDG uptake, which may be due to tumor cellularity, biological behaviors of the tumor cells, the composition and the proportion of inflammatory cells, and the extent of activation of the inflammatory cells. FDG PET/CT may be useful for detection of the primary tumors, local recurrences, and distant metastases.
本研究旨在回顾性评估炎症性肌纤维母细胞瘤（IMT）的 F-FDG PET/CT 表现及其与病理结果的相关性。
回顾性分析了 5 例 IMT 患者和 1 例由 IMT 转化而来的梭形细胞肉瘤患者的 FDG PET/CT 检查结果。所有 6 例患者均在术前进行了 PET/CT 扫描，其中 1 例患者进行了随访 FDG PET/CT 扫描。评估了肿瘤的位置、大小、最大标准化摄取值（SUVmax）和病理表现。分析了 FDG 摄取与病理结果之间的相关性。
6 例患者共检出 10 个病灶，肿瘤部位分别为肝（n=3）、腹膜后（n=2）、脾（n=1）、肺（n=1）和骨（n=3）。7 例 IMT 和 1 例由 IMT 转化而来的梭形细胞肉瘤均经病理证实。经病理证实的肿瘤 SUVmax 平均值为 10.9±5.5，肿瘤之间 SUVmax 变化较大，范围为 3.3～20.8。细胞密度高的肿瘤摄取 FDG 较多，细胞密度低的肿瘤摄取 FDG 相对较少。核异型性和较高增殖指数的肿瘤摄取 FDG 非常强，而增殖指数低或 Ki-67 染色阴性的肿瘤摄取 FDG 相对较低。1 个富含浆细胞的小肿瘤摄取 FDG 较高，1 个局灶性炎症细胞浸润的大肿瘤摄取 FDG 较低。1 例患者在切除后 7 个月的第二次 FDG PET/CT 扫描中发现局部复发和远处转移。
IMT 的 FDG 摄取量从低到高不等，这可能与肿瘤细胞密度、肿瘤细胞的生物学行为、炎症细胞的组成和比例以及炎症细胞的激活程度有关。FDG PET/CT 可能有助于检测原发性肿瘤、局部复发和远处转移。
