18F-氟脱氧葡萄糖正电子发射断层显像/X线计算机体层成像（18F-FDG PET/CT）在肺动脉肉瘤患者中的临床应用价值
Clinical utility of F-FDG PET/CT imaging in patients with pulmonary artery sarcoma.
作者信息
Ren Jingyun, Li Huiting, Zhang Qing, Liu Entao, Zeng Baozhen, Huang Yan, Wang Lan, Jiang Lei
机构信息
PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China.
Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China.
出版信息
EJNMMI Res. 2022 Apr 4;12(1):18. doi: 10.1186/s13550-022-00890-2.
BACKGROUND
Pulmonary artery sarcoma (PAS) is a rare and fatal malignancy. Due to the lack of specific clinical and radiological features, PAS is always misdiagnosed as pulmonary thromboembolism (PTE). This study aimed to investigate F-FDG PET/CT in distinguishing PAS from PTE, and analyze its correlation with clinical and radiological findings and outcome of PAS.
METHODS
Clinical, contrast-enhanced CT, and F-FDG PET/CT characteristics of 14 patients with PAS and 33 patients with PTE were retrospectively reviewed. The correlation between PET/CT metabolic parameters vs. clinical and CT findings was investigated in patients with PAS. The overall survival (OS) was analyzed in PAS patients.
RESULTS
The SUVmax of PAS (median: 8.0, range 3.0-17.2) was significantly higher than PTE (1.8[0.8-3.7]) (P < 0.001), and at a cutoff value of 2.9, the sensitivity and specificity were 100.0% and 93.9%, respectively. Compared with PTE, PAS more frequently occurred in younger population (P = 0.011), involved pulmonary trunk (P < 0.001), and displayed higher enhanced CT (P < 0.001) and ΔCT (enhanced CT compared to non-enhanced CT) (P < 0.001) values. SUVmax of PAS was associated with tumor staging (P = 0.022) and enhanced CT (P = 0.013) and ΔCT (P = 0.005) values. The median OS of PAS patients was 10.5 months, and 12-month and 24-month OS rates were 58.0% and 12.0%, respectively. Only D-dimer level (P = 0.038) and tumor staging (P = 0.019) were associated with OS.
CONCLUSIONS
Most PAS displayed high glucometabolism, and SUVmax of F-FDG PET/CT was useful in distinguishing PAS from PTE.
背景
肺动脉肉瘤（PAS）是一种罕见的致命性恶性肿瘤。由于缺乏特异性的临床和影像学特征，PAS常被误诊为肺血栓栓塞症（PTE）。本研究旨在探讨F-FDG PET/CT在鉴别PAS与PTE中的作用，并分析其与PAS临床、影像学表现及预后的相关性。
方法
回顾性分析14例PAS患者和33例PTE患者的临床、增强CT及F-FDG PET/CT特征。研究PAS患者PET/CT代谢参数与临床及CT表现之间的相关性。分析PAS患者的总生存期（OS）。
结果
PAS的最大标准摄取值（SUVmax）中位数为8.0，范围3.0-17.2，显著高于PTE的1.8（0.8-3.7）（P<0.001），截断值为2.9时，敏感性和特异性分别为100.0%和93.9%。与PTE相比，PAS更常见于年轻人群（P=0.011），累及肺动脉主干（P<0.001），增强CT值（P<0.001）和ΔCT（增强CT与平扫CT相比）（P<0.001）更高。PAS的SUVmax与肿瘤分期（P=0.022）、增强CT值（P=0.013）和ΔCT值（P=0.005）相关。PAS患者的中位OS为10.5个月，12个月和24个月的OS率分别为58.0%和12.0%。仅D-二聚体水平（P=0.038）和肿瘤分期（P=0.019）与OS相关。
结论
大多数PAS表现为高糖代谢，F-FDG PET/CT的SUVmax有助于鉴别PAS与PTE。
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