Surov Alexey, Pawelka Maria Kerstin, Wienke Andreas, Schramm Dominik
Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Acta Radiol. 2014 Feb;55(1):101-6. doi: 10.1177/0284185113493086. Epub 2013 Jul 24.
Skeletal muscle metastases (SMM) are very rare because of complex resistance of the musculature to metastatic invasion. Previously, positron emission tomography (PET) imaging of SMM has been reported only in few reports. A systematic analysis of SMM features in PET/CT has not been performed before.
To study PET/CT findings of SMM in a larger group of patients with known malignancies and to determine PET/CT patterns of SMM in different primary tumors.
Between January 2009 and December 2011 581 patients with lung cancer were investigated by PET with 18 F-fluordeoxyglucose (FDG PET) and computed tomography (CT) at the Center of Fusion Imaging, Halle. In five patients SMM were identified. Furthermore, PubMed database was screened for muscle metastases. Only articles containing SUV of SMM were considered in the study. Twenty-one articles with 33 patients could be included in this meta-analysis from the literature.
At our center the prevalence of SMM was 0.9%. Our analysis comprised 38 patients with 67 muscle metastases. All identified SMM presented as intramuscular focal abnormal activity with SUV ranging from 2.4 to 25.9, median SUV 7.8. The median size of the muscle metastases was 2.5 cm (range, 0.6-6.5 cm). There were no significant differences between SUV and size of SMM arising from lung cancer, renal cell carcinoma, and esophageal cancer. Also, there was no correlation between SUV and size of SMM (r = 0.101, P = 0.558) and between SUV of SMM and primary tumors (r = 0.138, P = 0.686). In nine (23.7%) of the 38 patients, the identified SMM were isolated distant metastases or isolated tumor recurrence.
SMM manifested on PET/CT as focal hypermetabolic intramuscular areas with different SUV. There were no significant differences between SUV or size of the identified SMM in esophageal cancer, renal cell carcinoma, and lung cancer.
由于肌肉组织对转移侵袭具有复杂的抵抗力，骨骼肌转移瘤（SMM）非常罕见。此前，仅有少数报告报道过SMM的正电子发射断层扫描（PET）成像。此前尚未对PET/CT中SMM的特征进行系统分析。
在更多已知恶性肿瘤的患者群体中研究SMM的PET/CT表现，并确定不同原发肿瘤中SMM的PET/CT模式。
2009年1月至2011年12月期间，哈雷融合成像中心对581例肺癌患者进行了18F-氟脱氧葡萄糖（FDG PET）正电子发射断层扫描和计算机断层扫描（CT）检查。其中5例患者被确诊为SMM。此外，对PubMed数据库进行了肌肉转移瘤筛查。本研究仅纳入包含SMM标准化摄取值（SUV）的文章。从文献中筛选出21篇包含33例患者的文章纳入本荟萃分析。
在我们中心，SMM的患病率为0.9%。我们的分析包括38例患者的67处肌肉转移瘤。所有确诊的SMM均表现为肌肉内局灶性异常活动，SUV范围为2.4至25.9，SUV中位数为7.8。肌肉转移瘤的中位数大小为2.5 cm（范围0.6 - 6.5 cm）。肺癌、肾细胞癌和食管癌引起的SMM在SUV和大小方面无显著差异。此外，SMM的SUV与大小之间（r = 0.101，P = 0.558）以及SMM的SUV与原发肿瘤之间（r = 0.138，P = 0.686）均无相关性。在38例患者中的9例（23.7%）中，确诊的SMM为孤立性远处转移或孤立性肿瘤复发。
SMM在PET/CT上表现为具有不同SUV的肌肉内局灶性高代谢区域。食管癌、肾细胞癌和肺癌中确诊的SMM在SUV或大小方面无显著差异。
