1 All authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea.
AJR Am J Roentgenol. 2014 Feb;202(2):W153-60. doi: 10.2214/AJR.13.10873.
The objective of our study was to evaluate the value that PET/CT adds to adrenal protocol CT for characterizing adrenal metastasis in oncologic patients.
Sixty-eight oncologic patients with 68 adrenal masses underwent both adrenal protocol CT and (18)F-FDG PET/CT. For adrenal protocol CT, metastasis was diagnosed if a mass measured more than 10 HU on unenhanced CT and if the absolute and relative percentage washouts were less than 60% and 40%, respectively. For PET/CT, metastasis was diagnosed if FDG uptake of the lesion was equal to or greater than that of the liver. Diagnostic accuracies were compared between these two imaging modalities.
The accuracy of adrenal protocol CT and PET/CT for a metastatic lesion, defined as a lesion with FDG uptake equal to or higher than that of the liver, was 85.3% (58/68) and 76.5% (52/68), respectively. However, the accuracy of PET/CT increased to 89.7% (61/68) when a lesion with high FDG uptake alone was considered a metastatic lesion. When both adrenal protocol CT and PET/CT were positive for metastasis, the accuracy increased to 91.2% (62/68), but the sensitivity decreased to 70.6% (12/17).
Adding PET/CT to adrenal protocol CT improves the accuracy for adrenal metastasis in oncologic patients when a lesion with high FDG uptake alone is considered metastasis.
我们研究的目的是评估 PET/CT 对肿瘤患者肾上腺转移瘤特征的附加价值。
68 例肾上腺肿块的肿瘤患者均行肾上腺方案 CT 和（18）F-FDG PET/CT 检查。对于肾上腺方案 CT，如果肿块在未增强 CT 上的测量值大于 10HU，且绝对和相对洗脱百分比分别小于 60%和 40%，则诊断为转移瘤。对于 PET/CT，如果病变的 FDG 摄取与肝脏相等或更高，则诊断为转移瘤。比较两种成像方式的诊断准确性。
肾上腺方案 CT 和 PET/CT 对转移瘤（定义为 FDG 摄取与肝脏相等或更高的病变）的准确性分别为 85.3%（58/68）和 76.5%（52/68）。然而，当仅考虑高 FDG 摄取的病变为转移瘤时，PET/CT 的准确性增加至 89.7%（61/68）。当肾上腺方案 CT 和 PET/CT 均提示转移时，准确性增加至 91.2%（62/68），但敏感性降至 70.6%（12/17）。
当仅考虑高 FDG 摄取的病变为转移瘤时，将 PET/CT 与肾上腺方案 CT 相结合可提高肿瘤患者肾上腺转移的准确性。
