Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.
Eur Radiol. 2015 Dec;25(12):3696-705. doi: 10.1007/s00330-015-3787-z. Epub 2015 Apr 30.
To compare F-18-fluorodeoxyglucose (FDG) and F-18-fluorothymidine (FLT) PET/CT examinations for differentiating between benign and malignant adrenal tumours.
Thirty lipid-poor benign and 11 malignant tumours of 40 patients were included. FDG- and FLT-based indices including visual score, maximum standardized uptake value (SUVmax) and FDG adrenal lesion/liver SUVmax (A/L SUVmax) or FLT adrenal lesion/back muscle SUVmax (A/B SUVmax) ratio were compared between benign and malignant tumours using the Mann-Whitney's U or Wilcoxon signed-rank test, and their diagnostic performances were evaluated by means of the area under the curve (AUC) values derived from the receiver operating characteristic analysis.
All indices were significantly higher in malignant than benign tumours on both images (p < 0.05 each). On FDG-PET/CT, the sensitivity, specificity, and accuracy were 91 %, 63 % and 71 % for visual score, 91 %, 67 % and 73 % for SUVmax, and 100 %, 70 % and 78 % for A/L SUVmax ratio, respectively. On FLT-PET/CT, they were 100 %, 97 % and 98 % for visual score, SUVmax and A/B SUVmax ratio, respectively. All FLT indices were significantly higher than those of FDG in AUC (p < 0.05 each).
FLT-PET/CT may be superior to FDG-PET/CT in differentiating lipid-poor benign from malignant adrenal tumours because of higher specificity and accuracy.
• All FDG indices were significantly higher in malignant than in benign tumours. • All FLT indices were significantly higher in malignant than in benign tumours. • All FLT indices were significantly higher than those of FDG in AUC.
比较 F-18-氟脱氧葡萄糖（FDG）和 F-18-氟胸腺嘧啶（FLT）PET/CT 检查在鉴别良恶性肾上腺肿瘤中的作用。
本研究纳入了 40 例患者的 30 个脂性乏血良性肿瘤和 11 个恶性肿瘤。使用 Mann-Whitney U 检验或 Wilcoxon 符号秩检验比较 FDG 和 FLT 基于指标（包括视觉评分、最大标准化摄取值（SUVmax）以及 FDG 肾上腺病变/肝脏 SUVmax（A/L SUVmax）或 FLT 肾上腺病变/背部肌肉 SUVmax（A/B SUVmax）比值）在良恶性肿瘤之间的差异，并通过受试者工作特征（ROC）曲线分析得出的曲线下面积（AUC）值来评估它们的诊断性能。
在两种图像上，恶性肿瘤的所有指标均显著高于良性肿瘤（p 值均<0.05）。在 FDG-PET/CT 上，视觉评分、SUVmax 和 A/L SUVmax 比值的敏感性、特异性和准确性分别为 91%、63%和 71%，91%、67%和 73%，100%、70%和 78%。在 FLT-PET/CT 上，视觉评分、SUVmax 和 A/B SUVmax 比值的敏感性、特异性和准确性分别为 100%、97%和 98%。所有 FLT 指标的 AUC 均显著高于 FDG（p 值均<0.05）。
FLT-PET/CT 可能优于 FDG-PET/CT，因为其具有更高的特异性和准确性，可用于鉴别脂性乏血的良性和恶性肾上腺肿瘤。
所有 FDG 指标在恶性肿瘤中均显著高于良性肿瘤。
所有 FLT 指标在恶性肿瘤中均显著高于良性肿瘤。
所有 FLT 指标的 AUC 均显著高于 FDG。
