Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030-4008, USA.
Department of Medical Imaging, St .Michael's Hospital, University of Toronto, Toronto, ON, M5B 1W8, Canada.
Abdom Radiol (NY). 2017 Feb;42(2):577-584. doi: 10.1007/s00261-016-0915-4.
To determine the diagnostic performance of PET-CT in differentiating benign and malignant adrenal lesions when evaluating PET parameters individually as well as in combination with CT parameters, using histopathology as the reference standard.
F-FDG-PET-CT scans of patients undertaken within 6 months prior to pathologic evaluation of their adrenal lesion(s) were evaluated. PET assessments consisted individually of maximum standardized uptake value of the adrenal lesion (A-SUV) and its ("normalized") ratio to the liver (R-SUV). The diagnostic performances of these two PET parameters were also assessed when combined with the Hounsfield density from the non-contrast CT component of the PET-CT (A-HU). Diagnostic performance was assessed by area under the curve (AUC) of the receiver operating characteristics. Multiple logistic regression analysis was used to evaluate the individual and combined parameters.
The study cohort consisted of 61 adrenal lesions (59 patients). Malignant lesions (n = 52) had significantly higher median PET and CT parameters than benign lesions: A-SUV (11.4 vs. 6.1), R-SUV (3.3 vs. 1.7), and A-HU (37 vs. 24) [all p < 0.023]. AUC for the PET parameters individually was almost identical: 0.75 for A-SUV and 0.74 for R-SUV. On univariate analysis, thresholds of A-SUV >3.47 and R-SUV >0.83 yielded maximum accuracy (both 87%). The combination of these PET parameters individually with A-HU improved both AUC and accuracy (0.81% and 93%, respectively).
The individual PET parameters A-SUV and R-SUV have similar diagnostic performance for differentiating malignant and benign adrenal lesions; their performance and accuracy improve when combined with the CT component (A-HU).
通过以病理结果为参考标准，评估氟-18 氟代脱氧葡萄糖正电子发射断层扫描（F-FDG-PET-CT）在分别评估 PET 参数以及联合 CT 参数时，对良、恶性肾上腺病变的诊断效能。
回顾性分析了 61 例患者的 F-FDG-PET-CT 扫描，这些患者的肾上腺病变在进行病理评估前的 6 个月内接受了 F-FDG-PET-CT 扫描。对每个患者的肾上腺病变的最大标准化摄取值（A-SUV）及其与肝脏的比值（R-SUV）进行了评估。同时，还评估了这两个 PET 参数与 F-FDG-PET-CT 非对比 CT 成分的亨氏单位（A-HU）联合时的诊断性能。通过受试者工作特征曲线（ROC）下面积（AUC）评估诊断性能。采用多变量逻辑回归分析评估各个和联合参数。
研究队列包括 61 个肾上腺病变（59 例患者）。恶性病变（n=52）的 PET 和 CT 参数明显高于良性病变：A-SUV（11.4 比 6.1）、R-SUV（3.3 比 1.7）和 A-HU（37 比 24）[均 P<0.023]。单独使用 PET 参数的 AUC 几乎相同：A-SUV 为 0.75，R-SUV 为 0.74。单变量分析显示，A-SUV>3.47 和 R-SUV>0.83 的阈值可获得最大准确性（均为 87%）。当这些 PET 参数分别与 A-HU 联合使用时，AUC 和准确性都有所提高（分别为 0.81%和 93%）。
A-SUV 和 R-SUV 这两个单独的 PET 参数在区分良、恶性肾上腺病变方面具有相似的诊断性能；当与 CT 成分（A-HU）联合使用时，它们的性能和准确性会提高。
