Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan.
Thorac Cancer. 2022 Jun;13(11):1651-1656. doi: 10.1111/1759-7714.14434. Epub 2022 Apr 22.
It is often difficult to distinguish between thymoma and thymic carcinoma by preoperative radiological tests. While there have been some reports that the maximum standardized uptake value (SUV ) in positron emission tomography-computed tomography (PET-CT) is useful to this end, no large-scale analysis has been performed. We therefore analyzed the usefulness of the SUV and tumor size (TS) for differentiating thymic epithelial tumors.
From 2011 to 2019, 129 patients with thymic epithelial tumor who underwent PET-CT before surgical treatment were enrolled. The relevance of the SUV to the World Health Organization (WHO) histological type was assessed. To reduce the impact of the TS, the ratio of the SUV to the TS was also investigated.
A total of 99 thymoma cases and 30 thymic carcinoma cases were enrolled into the study. The SUV and SUV /TS of thymic carcinoma were significantly higher than those of thymoma (SUV : 7.7 ± 3.4 vs. 3.3 ± 1.3, p < 0.01; SUV /TS: 1.5 ± 0.7 vs. 0.6 ± 0.4, p < 0.01). Focusing on the patients with a moderate SUV of ≤5 (84 thymoma and 4 thymic carcinoma), the SUV /TS values of thymic carcinoma were still significantly higher than those of thymoma (1.6 ± 0.8 vs. 0.6 ± 0.4, p < 0.01).
PET-CT might provide significant information for differentiating images of thymoma and thymic carcinoma. We experienced several cases of thymic carcinoma with a moderate SUV of ≤5, and SUV /TS was considered a useful parameter for differentiating such cases.
术前影像学检查常难以鉴别胸腺瘤和胸腺癌。有报道称正电子发射断层扫描-计算机断层扫描（PET-CT）的最大标准化摄取值（SUV）有助于鉴别，但尚未进行大规模分析。因此，我们分析了 SUV 和肿瘤大小（TS）在鉴别胸内上皮性肿瘤中的作用。
回顾性分析 2011 年至 2019 年 129 例行手术治疗的胸内上皮性肿瘤患者的 PET-CT 资料。评估 SUV 与世界卫生组织（WHO）组织学分型的相关性。为减少 TS 的影响，还研究了 SUV 与 TS 的比值。
共纳入 99 例胸腺瘤和 30 例胸腺癌患者。胸腺癌 SUV 和 SUV/TS 均显著高于胸腺瘤（SUV：7.7±3.4 比 3.3±1.3，p<0.01；SUV/TS：1.5±0.7 比 0.6±0.4，p<0.01）。关注 SUV 值≤5 的中等水平患者（84 例胸腺瘤和 4 例胸腺癌），胸腺癌 SUV/TS 仍显著高于胸腺瘤（1.6±0.8 比 0.6±0.4，p<0.01）。
PET-CT 可能为鉴别胸腺瘤和胸腺癌的影像学表现提供重要信息。我们遇到数例 SUV 值≤5 的胸腺癌，SUV/TS 被认为是鉴别此类病例的有用参数。
