The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
J Nucl Cardiol. 2022 Oct;29(5):2378-2389. doi: 10.1007/s12350-021-02723-6. Epub 2021 Jul 27.
The purpose of this study was to retrospectively evaluate the value of F-FDG PET/CT integrated with contrast-enhanced CT (CECT) in the differential diagnosis of primary cardiac lymphomas (PCLs) and primary cardiac angiosarcomas (PCAs).
Clinical and imaging data of patients with PCLs and PCAs were collected. All patients underwent preoperative F-FDG PET/CT and thoracic CECT. The enhancement pattern and tumor morphology were analyzed using CECT images. The intensity- and volume-based PET parameters of cardiac lesions were analyzed. The performance characteristics of all parameters were assessed.
Nine patients with PCL and eight patients with PCA were analyzed. There were significant differences in SUVmax (t = 3.790, P = .002), SUVmean (t = 4.273, P = .001), metabolic tumor volume (U = 13.00, P = .027), tumor-to-liver ratio (U = 10.00, P = .011), and total lesion glycolysis (U = 4.0, P = .001) between PCLs and PCAs. There were significant differences in the enhancement pattern of tumors (P = .002) and tumor morphology (P = .015). The combination of F-FDG PET/CT and CECT improved the diagnostic accuracy, and the combination cutoff (SUVmean > 5.17) could reach 100%, but the difference was not statistically significant (P > .05).
The intensity- and volume-based PET parameters of PCL were significantly higher than those of PCA. The enhancement pattern and tumor morphology were also different. According to these characteristics, the two most common types of primary cardiac malignancies can be differentiated.
本研究旨在回顾性评估 F-FDG PET/CT 与增强 CT（CECT）联合在原发性心脏淋巴瘤（PCL）和原发性心脏血管肉瘤（PCA）鉴别诊断中的价值。
收集了 PCL 和 PCA 患者的临床和影像学资料。所有患者均行术前 F-FDG PET/CT 和胸部 CECT 检查。使用 CECT 图像分析增强模式和肿瘤形态。分析心脏病变的基于强度和基于体积的 PET 参数。评估所有参数的性能特征。
共分析了 9 例 PCL 患者和 8 例 PCA 患者。SUVmax（t=3.790，P=.002）、SUVmean（t=4.273，P=.001）、代谢肿瘤体积（U=13.00，P=.027）、肿瘤与肝脏比值（U=10.00，P=.011）和总病变糖酵解（U=4.0，P=.001）在 PCL 和 PCA 之间存在显著差异。肿瘤的增强模式（P=.002）和肿瘤形态（P=.015）存在显著差异。F-FDG PET/CT 与 CECT 的联合应用提高了诊断准确性，联合截断值（SUVmean＞5.17）可达到 100%，但差异无统计学意义（P＞.05）。
PCL 的基于强度和基于体积的 PET 参数明显高于 PCA。增强模式和肿瘤形态也不同。根据这些特征，可以对两种最常见的原发性心脏恶性肿瘤进行鉴别诊断。
