Wang Kai, Zhao Xiaobin, Chen Qian, Fan Di, Qiao Zhen, Lin Song, Jiang Tao, Dai Jianping, Ai Lin
Department of Nuclear Medicine Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University China National Clinical Research Center for Neurological Diseases Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor Beijing Neurosurgical Institute Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2017 Aug;96(32):e7756. doi: 10.1097/MD.0000000000007756.
Intracranial gliomas and lymphomas may share similar radiological manifestations, while the treatment strategies for them are different. The aim of the study was to investigate the diagnostic value of fluorine-18-fluoro-2-deoxy-D-glucose (F-FDG) positron emission computed tomography (PET) for differentiation of multicentric gliomas and intracranial multiple diffuse large B-cell lymphomas (DLBCLs) as a study of diagnostic accuracy.A total of 32 patients with multiple intracranial tumors visualized on contrast-enhanced magnetic resonance imaging (MRI) were retrospectively evaluated. Histopathological findings confirmed multicentric gliomas and multiple DLBCLs in 17 and 15 patients, respectively. All patients underwent F-FDG PET with or without C-methionine PET. Maximum standardized uptake values (SUVmax) and tumor-to-normal tissue (T/N) ratios were compared between the 2 tumors. The diagnostic value of F-FDG PET for differentiating multicentric gliomas from multiple DLBCLs was evaluated by receiver operating characteristic (ROC) analysis.The SUVmax of multiple DLBCLs was significantly higher than that of multicentric gliomas (P = .009). However, the percentage of maximum difference-value of SUVmax (or T/N ratio) of multiple DLBCLs was significant lower than that of multicentric gliomas (P < .001). The ROC curve demonstrated that the percentage of maximum difference-value of SUVmax (or T/N ratio) on F-FDG PET images could effectively differentiate multicentric gliomas from multiple DLBCLs, with a cut-off value of 44.4%, sensitivity of 64.7%, and specificity of 100% (P < .001).Percentage of maximum difference-value of SUVmax (or T/N ratio) on F-FDG PET images might be a potential indicator for distinguishing multicentric gliomas from intracranial multiple DLBCLs, which might help determine the treatment strategy.
颅内胶质瘤和淋巴瘤可能具有相似的影像学表现，但其治疗策略不同。本研究的目的是探讨氟-18-氟-2-脱氧-D-葡萄糖（F-FDG）正电子发射计算机断层显像（PET）在鉴别多中心胶质瘤和颅内多发弥漫性大B细胞淋巴瘤（DLBCL）中的诊断价值，作为一项诊断准确性研究。对32例在对比增强磁共振成像（MRI）上显示有多个颅内肿瘤的患者进行了回顾性评估。组织病理学结果分别证实17例患者为多中心胶质瘤，15例患者为多发DLBCL。所有患者均接受了F-FDG PET检查，部分患者还接受了C-蛋氨酸PET检查。比较了两种肿瘤的最大标准化摄取值（SUVmax）和肿瘤与正常组织（T/N）比值。通过受试者操作特征（ROC）分析评估F-FDG PET对鉴别多中心胶质瘤和多发DLBCL的诊断价值。多发DLBCL的SUVmax显著高于多中心胶质瘤（P = 0.009）。然而，多发DLBCL的SUVmax（或T/N比值）最大差值百分比显著低于多中心胶质瘤（P < 0.001）。ROC曲线显示，F-FDG PET图像上SUVmax（或T/N比值）最大差值百分比可有效鉴别多中心胶质瘤和多发DLBCL，截断值为44.4%，灵敏度为64.7%，特异性为100%（P < 0.001）。F-FDG PET图像上SUVmax（或T/N比值）最大差值百分比可能是区分多中心胶质瘤和颅内多发DLBCL的潜在指标，这可能有助于确定治疗策略。
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