Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Cancer Biol Med. 2020 May 15;17(2):468-477. doi: 10.20892/j.issn.2095-3941.2019.0428.
A high rate of unnecessary thymectomies has been reported. This study aimed to distinguish primary mediastinal lymphomas (PMLs) from thymic epithelial tumors (TETs) by evaluating volumetric and metabolic parameters with F-FDG PET/CT. A total of 136 patients who were pathologically diagnosed with TETs or PMLs were enrolled, and F-FDG PET/CT was performed before therapy. Volumetric parameters, including the mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and SUVmax, were determined and compared between the 2 subtypes. The diagnostic performance of these parameters was evaluated with receiver operating characteristic (ROC) curve analysis. All parameters significantly differed between patients with PMLs and TETs. Patients with lymphomas were younger and had higher SUVmean, SUVmax, TLG, and MTV values than patients with TETs. The MTV and TLG values had similar diagnostic performance. ROC analysis indicated that the areas under the curves of the SUVmean and SUVmax values performed similarly (approximately 0.76) in differentiating patients with PMLs from TETs, and both values were better than the MTV and TLG values. When age was included with the SUVmax in differentiating TETs from PMLs, the AUC was 0.91, and the sensitivity and specificity increased to 80% and 93%, respectively. The SUVmax and volumetric parameters of F-FDG PET/CT can be used to distinguish patients with PMLs versus TETs, and thus may aid in preventing unnecessary thymectomies or other invasive operations.
已有报道称，胸腺切除术的不必要率很高。本研究旨在通过评估 F-FDG PET/CT 的容积和代谢参数，将原发性纵隔淋巴瘤（PML）与胸腺癌（TET）区分开来。共纳入 136 例经病理诊断为 TET 或 PML 的患者，在治疗前进行 F-FDG PET/CT 检查。测定并比较了两组患者的容积参数，包括平均 SUV（SUVmean）、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和 SUVmax。采用受试者工作特征（ROC）曲线分析评估这些参数的诊断性能。所有参数在 PML 和 TET 患者之间均有显著差异。淋巴瘤患者较 TET 患者年轻，且 SUVmean、SUVmax、TLG 和 MTV 值更高。MTV 和 TLG 值具有相似的诊断性能。ROC 分析表明，SUVmean 和 SUVmax 值区分 PML 和 TET 患者的曲线下面积（AUC）相似（约为 0.76），且均优于 MTV 和 TLG 值。当将 SUVmax 值与年龄结合起来区分 TET 和 PML 时，AUC 为 0.91，灵敏度和特异性分别提高至 80%和 93%。F-FDG PET/CT 的 SUVmax 和容积参数可用于区分 PML 和 TET 患者，从而可能有助于避免不必要的胸腺切除术或其他侵袭性手术。
