评估腭扁桃体的生理性和异常葡萄糖摄取：连续双时相 2-脱氧-2-[18F]FDG PET/CT 的鉴别诊断。
Evaluation of physiologic and abnormal glucose uptake in palatine tonsils: differential diagnostics with sequential dual-time-point 2-deoxy-2-[18F]FDG PET/CT.
机构信息
Department of Nuclear Medicine, Greater Poland Cancer Center, Poznan, Poland -
Department of Electroradiology, University of Medical Science, Poznan, Poland.
出版信息
Q J Nucl Med Mol Imaging. 2020 Sep;64(3):299-306. doi: 10.23736/S1824-4785.18.03065-0. Epub 2018 Sep 13.
BACKGROUND
The aim of this article was to evaluate the usefulness of sequential dual-time-point 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (DTP [18F]FDG PET/CT) in distinguishing physiologic, inflammatory and malignant palatine tonsils as difficult to differentiate in the oncological practice.
METHODS
A total of 90 patients before the treatment underwent sequential DTP [18F]FDG PET/CT examinations. We analyzed 104 structures in 90 patients: 31 physiologic tonsils, 28 histopathologically confirmed inflammatory tonsils of non-specified origin, 31 histopathologically confirmed palatine tonsils cancer and 14 non-malignant contralateral tonsils in patients with histopathologically confirmed unilateral palatine tonsil malignancy. Patients underwent sequential [18F]FDG PET/CT examinations at 60 and 90 minutes post-injection of the [18F]FDG. We analyzed the SUVmax and SUVmean values at 60 and 90 minutes post-injection changes over time and the Retention Index (RI-SUVmax). To find the predictive SUV value and the RI cut-off between physiology, inflammatory and malignancy, we used the ROC analysis.
RESULTS
The average SUVmax values at 60 and 90minutes post-injection within physiologic palatine tonsils were 1.36±0.26 and 1.31±0.26, respectively, P>0.05. The average SUVmax values at 60 and 90 minutes post-injection within inflammatory and malignant tonsils were 3.74±1.45, 3.80±1.47 (P>0.05) and 5.19±2.19, 5.81±2.50 (P<0.05), respectively. The RI-SUVmax fluctuation over time were 5±28% within physiologic, -4±11% within contralateral non-malignant tonsils in patients with one tonsil involved, 2±11% within inflammatory and 13±13% within malignant tonsils.
CONCLUSIONS
The sequential dual-time-point [18F]FDG PET/CT examinations may increase the sensitivity and the specificity of the PET/CT method in differential palatine tonsils diagnosis.
背景
本文旨在评估序贯双时相 2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（DTP [18F]FDG PET/CT）在鉴别难以区分的肿瘤学实践中生理性、炎症性和恶性的硬腭扁桃体的有用性。
方法
90 名治疗前患者接受了序贯 DTP [18F]FDG PET/CT 检查。我们分析了 90 名患者的 104 个结构：31 个生理性扁桃体、28 个组织学证实的非特异性来源的炎症性扁桃体、31 个组织学证实的腭扁桃体癌和 14 个在组织学证实的单侧腭扁桃体癌患者中对侧非恶性扁桃体。患者在注射 [18F]FDG 后 60 和 90 分钟接受序贯 [18F]FDG PET/CT 检查。我们分析了注射后 60 和 90 分钟 SUVmax 和 SUVmean 值随时间的变化以及保留指数（RI-SUVmax）。为了找到生理学、炎症和恶性之间的预测 SUV 值和 RI 截止值，我们使用了 ROC 分析。
结果
生理性腭扁桃体 60 分钟和 90 分钟 SUVmax 平均值分别为 1.36±0.26 和 1.31±0.26，P>0.05。炎症性和恶性扁桃体 60 分钟和 90 分钟 SUVmax 平均值分别为 3.74±1.45、3.80±1.47（P>0.05）和 5.19±2.19、5.81±2.50（P<0.05）。生理性扁桃体 60 分钟和 90 分钟 SUVmax 平均值分别为 60 分钟和 90 分钟的 RI-SUVmax 波动值为 5±28%，单侧扁桃体受累患者对侧非恶性扁桃体为-4±11%，炎症性为 2±11%，恶性为 13±13%。
结论
序贯双时相 [18F]FDG PET/CT 检查可能会提高 PET/CT 方法在鉴别腭扁桃体诊断中的敏感性和特异性。
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