Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, No.507 Zhengmin Road, Shanghai 200433, China.
Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, No.507 Zhengmin Road, Shanghai 200433, China.
Acad Radiol. 2022 Feb;29 Suppl 2:S41-S46. doi: 10.1016/j.acra.2020.10.022. Epub 2020 Nov 9.
To assess the possibility of differentiating pulmonary carcinoids from hamartomas and typical from atypical carcinoids by means of F-FDG PET/CT.
We retrospectively reviewed 139 patients with pathologically proven pulmonary carcinoids and hamartomas who underwent F-FDG PET/CT before surgical resection. Receiver operating characteristics curves were calculated to determine the potential of SUVmax to discriminate between pulmonary carcinoids and hamartomas, typical and atypical carcinoids. The correlation between SUVmax and tumor size was analyzed by Spearman correlation analysis.
SUVmax was significantly higher in pulmonary carcinoids than in hamartomas (p<0.001), and also higher in atypical carcinoids than in typical carcinoids (p = 0.034). With a SUVmax of 2.0 as a cutoff, the sensitivity, specificity, positive predictive value, and negative predictive value for F-FDG PET/CT to differentiate pulmonary carcinoids from hamartomas were 85.3%, 82.9%, 61.7%, and 94.6%, respectively. The cutoff value of SUVmax for differentiating atypical carcinoids from typical carcinoids was 4.1. The area under the receiver operating characteristics curve of SUVmax was 0.900 for carcinoids and hamartomas, and 0.722 for typical and atypical carcinoids. SUVmax was correlated with maximum tumor size in pulmonary carcinoids (r = 0.658, p <0.001) and in pulmonary hamartomas (r = 0.672, p <0.001).
F-FDG PET/CT might be a useful tool in the differential diagnosis of carcinoids and hamartomas, and can also distinguish atypical from typical carcinoids. This may facilitate improved selection of patients for surgical resection and radiological follow-up.
评估 F-FDG PET/CT 对肺类癌与错构瘤、典型类癌与不典型类癌的鉴别诊断价值。
回顾性分析 139 例经病理证实的肺类癌与错构瘤患者的 F-FDG PET/CT 资料。计算 SUVmax 鉴别肺类癌与错构瘤、典型类癌与不典型类癌的受试者工作特征曲线下面积（AUC），采用 Spearman 相关分析评估 SUVmax 与肿瘤大小的相关性。
肺类癌的 SUVmax 显著高于错构瘤（p<0.001），不典型类癌也显著高于典型类癌（p=0.034）。以 SUVmax 为 2.0 为界值时，F-FDG PET/CT 鉴别肺类癌与错构瘤的敏感度、特异度、阳性预测值、阴性预测值分别为 85.3%、82.9%、61.7%、94.6%。鉴别不典型类癌与典型类癌的 SUVmax 界值为 4.1。SUVmax 鉴别肺类癌与错构瘤、典型类癌与不典型类癌的 AUC 分别为 0.900、0.722。肺类癌与肺错构瘤的 SUVmax 与肿瘤最大径均呈正相关（r=0.658，p<0.001；r=0.672，p<0.001）。
F-FDG PET/CT 有助于肺类癌与错构瘤的鉴别诊断，还能区分不典型类癌与典型类癌，有助于提高手术切除和影像学随访的针对性。
