Salamon Johannes, Veldhoen Simon, Apostolova Ivayla, Bannas Peter, Yamamura Jin, Herrmann Jochen, Friedrich Reinhard E, Adam Gerhard, Mautner Victor F, Derlin Thorsten
Department of Diagnostic and Interventional Radiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany,
Eur Radiol. 2014 Feb;24(2):405-12. doi: 10.1007/s00330-013-3020-x. Epub 2013 Oct 5.
To evaluate the usefulness of normalising intra-tumour tracer accumulation on (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to reference tissue uptake for characterisation of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1) compared with the established maximum standardised uptake value (SUVmax) cut-off of >3.5.
Forty-nine patients underwent FDG PET/CT. Intra-tumour tracer uptake (SUVmax) was normalised to three different reference tissues (tumour-to-liver, tumour-to-muscle and tumour-to-fat ratios). Receiver operating characteristic (ROC) analyses were used out to assess the diagnostic performance. Histopathology and follow-up served as the reference standard.
Intra-tumour tracer uptake correlated significantly with liver uptake (rs= 0.58, P = 0.016). On ROC analysis, the optimum threshold for tumour-to-liver ratio was >2.6 (AUC = 0.9735). Both the SUVmax cut-off value of >3.5 and a tumour-to-liver ratio >2.6 provided a sensitivity of 100 %, but specificity was significantly higher for the latter (90.3% vs 79.8%; P = 0.013).
In patients with NF1, quantitative (18)F-FDG PET imaging may identify malignant change in neurofibromas with high accuracy. Specificity could be significantly increased by using the tumour-to-liver ratio. The authors recommend further evaluation of a tumour-to-liver ratio cut-off value of >2.6 for diagnostic intervention planning.
• (18)F-FDG PET/CT is used for detecting malignancy in PNSTs in NF1 patients • An SUV max cut-off value may give false-positive results for benign plexiform neurofibromas • Specificity can be significantly increased using a tumour-to-liver ratio.
评估在18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）中，将肿瘤内示踪剂摄取标准化为参考组织摄取，以用于1型神经纤维瘤病（NF1）中外周神经鞘瘤（PNSTs）特征描述的有用性，并与既定的最大标准化摄取值（SUVmax）截断值>3.5进行比较。
49例患者接受了FDG PET/CT检查。肿瘤内示踪剂摄取（SUVmax）被标准化为三种不同的参考组织（肿瘤与肝脏、肿瘤与肌肉以及肿瘤与脂肪的比值）。采用受试者操作特征（ROC）分析来评估诊断性能。组织病理学和随访作为参考标准。
肿瘤内示踪剂摄取与肝脏摄取显著相关（rs = 0.58，P = 0.016）。在ROC分析中，肿瘤与肝脏比值的最佳阈值为>2.6（曲线下面积[AUC] = 0.9735）。SUVmax截断值>3.5和肿瘤与肝脏比值>2.6的敏感性均为100%，但后者的特异性显著更高（90.3%对79.8%；P = 0.013）。
在NF1患者中，定量18F-FDG PET成像可高精度识别神经纤维瘤的恶性变化。使用肿瘤与肝脏比值可显著提高特异性。作者建议进一步评估肿瘤与肝脏比值截断值>2.6用于诊断干预计划。
• 18F-FDG PET/CT用于检测NF1患者PNSTs中的恶性肿瘤 • SUVmax截断值可能会使良性丛状神经纤维瘤出现假阳性结果 • 使用肿瘤与肝脏比值可显著提高特异性
