1. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center;
2. Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center;
J Cancer. 2014 Mar 22;5(5):328-35. doi: 10.7150/jca.8310. eCollection 2014.
To assess the diagnostic performance of (18)F-FDG PET-CT in differentiating soft tissue sarcomas (STSs) from benign fluid collections (BFs).
Four readers independently reviewed 100 lesions on (18)F-FDG PET-CT and subjectively classified each lesion as an STS or BF and scored the spatial pattern of (18)F-FDG avidity (SP) of each on a 4-point ordered scale (thin, moderate, thick, solid).
Subjective assessment by readers allowed sensitive (91%-98%) differentiation of STSs from BFs, with lower specificity (59%-91%). The STSs had significantly higher SUVmax (median 10.7, range: 2.0-33.7) than BFs (median 2.8, range: 1.1-12.3). Reader agreement in assessment of SP had average κ = 0.61 (range 0.46-0.70). Classification of thick or solid SP as STS yielded an inter-reader averaged sensitivity and specificity of 69% and 98%, respectively. The presence of thick or solid SP resulted in 14.1-fold increase in partial odds of STS. Each unit increase in SUVmax resulted in 1.35-fold increase in partial odds of STS. The receiver operating characteristic (ROC) curves and 95% intervals for SUVmax alone and SUVmax + SP overlapped. The average subjective assessments for the four readers and estimated performance of using SP alone were both contained within the 95% intervals of the two ROC curves.
(18)F-FDG PET-CT is a sensitive modality for differentiating STSs from BFs. SUVmax and SP are significantly associated with STS. Classification schemes based upon SUVmax alone or augmented with SP can be useful for distinguishing STS from BF.
评估 (18)F-FDG PET-CT 区分软组织肉瘤 (STS) 与良性积液 (BF) 的诊断性能。
四位读者独立分析了 (18)F-FDG PET-CT 上的 100 处病灶，主观地将每个病灶归类为 STS 或 BF，并对病灶 (18)F-FDG 摄取的空间分布模式 (SP) 进行 4 分制评分（稀疏、中度、密集、弥漫）。
读者的主观评估能够敏感地区分 STS 与 BF（敏感度为 91%-98%），但特异性较低（59%-91%）。STS 的 SUVmax（中位数 10.7，范围：2.0-33.7）显著高于 BF（中位数 2.8，范围：1.1-12.3）。读者对 SP 的评估具有平均 κ 值为 0.61（范围 0.46-0.70）的一致性。将密集或弥漫性 SP 分类为 STS 时，读者间平均敏感度和特异度分别为 69%和 98%。存在密集或弥漫性 SP 会使 STS 的偏似然比增加 14.1 倍。SUVmax 每增加 1 单位，STS 的偏似然比增加 1.35 倍。SUVmax 单独和 SUVmax+SP 的 ROC 曲线及其 95%区间存在重叠。四位读者的平均主观评估和单独使用 SP 的估计性能均在两条 ROC 曲线的 95%区间内。
(18)F-FDG PET-CT 是一种敏感的区分 STS 与 BF 的方法。SUVmax 和 SP 与 STS 显著相关。基于 SUVmax 或联合 SP 的分类方案可用于区分 STS 与 BF。
