Department of Nuclear Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Department of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Ann Nucl Med. 2022 May;36(5):429-438. doi: 10.1007/s12149-022-01723-x. Epub 2022 Feb 8.
To date, published studies have shown that F-FDG PET/CT and CT have limited value in differentiating benign and malignant solitary fibrous tumours of the pleura (SFTP). This study aimed to determine whether the metabolic and morphological characteristics of F-FDG PET/CT can be a valuable addition to diagnostic tools for SFTPs.
From January 2016 to November 2021, we performed a retrospective review in 32 SFTPs patients who underwent F-FDG PET/CT scan. All the SFTP diagnoses were confirmed by surgical resection or biopsy samples. The metabolic parameters (including SUVmax, SUVmean, MTV, TLG, and SULmax) were obtained from F-FDG PET/CT images.
Thirty-two patients with SFTP were consecutively identified. The malignant SFTPs have higher Ki-67 expression (P = 0.005). The study observed that tumour heterogeneity without contrast injection (P = 0.001) and intratumor blood vessels (P = 0.047) were morphological features associated with malignant SFTP. Malignant SFTP was more frequently observed with higher SUVmax values (P = 0.001), higher SUVmean values (P = 0.001), higher TLG values (P = 0.006), and higher SULmax values (P < 0.001). For predicting malignant SFTP, the AUC values of SUVmax, SUVmean, TLG, and SULmax obtained by the area under curve analysis were 0.970 (95% CI 0.907-1.000; P = 0.001), 0.874 (95% CI 0.675-1.000; P = 0.009), 0.807 (95% CI 0.654-0.961; P = 0.031), and 0.911 (95% CI 0.747-1.000; P = 0.004), respectively.
The study showed that metabolic and morphological features were useful for distinguishing malignant from benign SFTPs.
迄今为止,已发表的研究表明,18F-FDG PET/CT 和 CT 对区分胸膜孤立性纤维瘤(SFTP)的良恶性有限。本研究旨在确定 18F-FDG PET/CT 的代谢和形态特征是否可以成为 SFTP 诊断工具的有价值补充。
本研究回顾性分析了 2016 年 1 月至 2021 年 11 月间 32 例接受 18F-FDG PET/CT 扫描的 SFTP 患者。所有 SFTP 诊断均通过手术切除或活检样本证实。从 18F-FDG PET/CT 图像中获得代谢参数(包括 SUVmax、SUVmean、MTV、TLG 和 SULmax)。
连续鉴定出 32 例 SFTP 患者。恶性 SFTP 的 Ki-67 表达更高(P=0.005)。研究观察到无对比注射的肿瘤异质性(P=0.001)和肿瘤内血管(P=0.047)是与恶性 SFTP 相关的形态特征。恶性 SFTP 更常表现出更高的 SUVmax 值(P=0.001)、更高的 SUVmean 值(P=0.001)、更高的 TLG 值(P=0.006)和更高的 SULmax 值(P<0.001)。用于预测恶性 SFTP,通过曲线下面积分析获得的 SUVmax、SUVmean、TLG 和 SULmax 的 AUC 值分别为 0.970(95%CI 0.907-1.000;P=0.001)、0.874(95%CI 0.675-1.000;P=0.009)、0.807(95%CI 0.654-0.961;P=0.031)和 0.911(95%CI 0.747-1.000;P=0.004)。
本研究表明,代谢和形态特征有助于区分恶性和良性 SFTP。