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.
Abdom Radiol (NY). 2017 Dec;42(12):2882-2889. doi: 10.1007/s00261-017-1207-3.
To retrospectively investigate the SUV-related and texture parameters individually and in combination for differentiating between F-18-fluorodeoxyglucose (FDG)-avid benign and metastatic adrenal tumors with PET/CT.
Thirteen benign adrenal tumors (BATs) and 22 metastatic adrenal tumors (MATs) with a metabolic tumor volume (MTV) > 10.0 cm and SUV ≥ 2.5 were included. SUVmax, MTV, total lesion glycolysis, and four textural parameters [entropy, homogeneity, intensity variability (IV), and size-zone variability] were obtained. These parameters were compared between BATs and MATs using Mann-Whitney U test, and the diagnostic performance was evaluated by the area under the curve (AUC) values derived from the receiver operating characteristic analysis. The diagnostic value of combining SUV and texture parameters was examined using a scoring system.
MATs showed significantly higher SUV (p = 0.004), entropy (p = 0.013), IV (p = 0.006), and lower homogeneity (p = 0.019) than BATs. The accuracies for diagnosing MATs were 82.9, 82.9, 85.7, and 71.4% for SUV, entropy, IV, and homogeneity, respectively. No significant differences in AUC were found among these parameters (p > 0.05 each). When each parameter was scored as 0 (negative for malignancy) and 1 (positive for malignancy) according to each threshold criterion and the four parameter summed scores 0, 1, and 2 were defined as benignity and 3 and 4 as malignancy, the sensitivity and specificity and accuracy to predict MATs were 100% (22/22), 84.6% (11/13), and 94.3% (33/35), respectively, with 0.97 of the AUC.
The combined use of SUV and texture parameters has a potential to significantly increase the diagnostic performance to differentiate between large FDG-avid BATs and MATs.
回顾性研究 SUV 相关参数和纹理参数单独及联合应用于 PET/CT 鉴别 F-18-氟脱氧葡萄糖（FDG）摄取的良性和转移性肾上腺肿瘤。
纳入 13 例代谢肿瘤体积（MTV）>10.0 cm 和 SUV≥2.5 的良性肾上腺肿瘤（BAT）和 22 例转移性肾上腺肿瘤（MAT）。获取 SUVmax、MTV、总肿瘤糖酵解（TLG）和 4 个纹理参数[熵、同质性、强度变异性（IV）和大小区变异性]。采用 Mann-Whitney U 检验比较 BAT 和 MAT 之间的这些参数，通过受试者工作特征分析得到的曲线下面积（AUC）值评估诊断性能。通过评分系统检查 SUV 和纹理参数联合的诊断价值。
MAT 的 SUV（p=0.004）、熵（p=0.013）、IV（p=0.006）显著高于 BAT，而同质性（p=0.019）显著低于 BAT。SUV、熵、IV 和同质性诊断 MAT 的准确率分别为 82.9%、82.9%、85.7%和 71.4%。这些参数的 AUC 之间无显著差异（p>0.05 每个）。当根据每个阈值标准将每个参数评分 0（恶性为阴性）和 1（恶性为阳性），并且将四个参数总和评分 0、1 和 2 定义为良性，3 和 4 定义为恶性时，预测 MAT 的敏感性、特异性和准确率分别为 100%（22/22）、84.6%（11/13）和 94.3%（33/35），AUC 为 0.97。
SUV 和纹理参数的联合使用有可能显著提高鉴别大 FDG 摄取的 BAT 和 MAT 的诊断性能。
