Department of Nuclear medicine of Comenius University and St Elisabeth Oncology Institute, Bratislava, Slovakia.
First Department of Internal Medicine of Comenius University and University Hospital of Bratislava, Bratislava, Slovakia.
Clin Nucl Med. 2022 Apr 1;47(4):305-313. doi: 10.1097/RLU.0000000000004049.
Endometriosis is a common gynecologic condition that may be visualized on 18F-FDG PET/CT and mimic lesions of malignancy. We analyzed the interference of known or suspected endometriosis in reporting 18F-FDG PET/CT performed in another indication.
The PET/CT images of 18 women with known (n = 15) or suspected (n = 3) endometriosis were analyzed. Based on clinical follow-up and results of other imaging, biopsy, and/or postsurgical histology, the presence of lesions of endometriosis at the time of 18F-FDG PET/CT was confirmed in 13 of 18 patients (72%). The per-patient positivity rate of 18F-FDG PET/CT was 8/18 (44%; 95% confidence interval, 22%-69%). The patient-based detection rate of 18F-FDG PET/CT in patients with confirmed lesions of endometriosis was 8/13 (62%; confidence interval, 32%-86%). On per-lesion/site basis, 18F-FDG PET/CT detected 11 of 20 sites (55%) of endometriosis. The SUVmax of these lesions/sites ranged between 1.8 and 5.3 (median, 3.8). In 9 of 18 patients (50%), a total of 13 non-endometriosis-related lesions/sites were detected by 18F-FDG PET/CT; their SUVmax ranged between 2.7 and 23 (median, 9.4).
The interference of known or suspected endometriosis in reporting 18F-FDG PET/CT performed in another indication was limited but possible and should be kept in mind, even in postmenopausal women, as the oldest patient with 18F-FDG-positive endometriosis was aged 63 years. The lesions of endometriosis showed inconstant 18F-FDG uptake with overlap of SUVmax with low-grade malignancies. In our series, the greatest SUVmax value of lesion of endometriosis was 5.3, somewhat higher than the threshold of 4 previously proposed for identification of malignant transformation of endometriosis.
子宫内膜异位症是一种常见的妇科疾病，在 18F-FDG PET/CT 上可见，并可能模仿恶性肿瘤的病变。我们分析了已知或疑似子宫内膜异位症对另一种适应证的 18F-FDG PET/CT 报告的干扰。
对 18 名已知（n=15）或疑似（n=3）子宫内膜异位症的女性的 PET/CT 图像进行了分析。根据临床随访以及其他影像学、活检和/或术后组织学结果，在 18 名患者中的 13 名（72%）证实了 18F-FDG PET/CT 时存在子宫内膜异位症的病变。18F-FDG PET/CT 的每例患者阳性率为 8/18（44%；95%置信区间，22%-69%）。在证实有子宫内膜异位症病变的患者中，18F-FDG PET/CT 的患者检出率为 8/13（62%；置信区间，32%-86%）。在每处病变/部位的基础上，18F-FDG PET/CT 检测到 20 处（55%）子宫内膜异位症中的 11 处。这些病变/部位的 SUVmax 范围为 1.8 至 5.3（中位数，3.8）。在 18 名患者中的 9 名（50%）中，18F-FDG PET/CT 共检测到 13 处非子宫内膜异位症相关病变/部位；其 SUVmax 范围为 2.7 至 23（中位数，9.4）。
已知或疑似子宫内膜异位症对另一种适应证的 18F-FDG PET/CT 报告的干扰是有限的，但也是可能的，即使在绝经后妇女中也应考虑到这一点，因为患有 18F-FDG 阳性子宫内膜异位症的最年长患者为 63 岁。子宫内膜异位症的病变显示出不一致的 18F-FDG 摄取，SUVmax 与低级别恶性肿瘤重叠。在我们的系列中，子宫内膜异位症病变的最大 SUVmax 值为 5.3，略高于之前提出的 4 作为识别子宫内膜异位症恶性转化的阈值。
