Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
Department of Radiation Oncology, No. 9 People Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai 201999, China.
Contrast Media Mol Imaging. 2022 Jun 15;2022:1926797. doi: 10.1155/2022/1926797. eCollection 2022.
The metabolic parameters which included mean standardised uptake value (SUVmean), metabolic tumour volume (MTV), total lesion glycolysis (TLG), maximum standardised uptake lean body mass (SULmax), and maximum standardised uptake body surface area (SUVbsa) have rarely been investigated in pulmonary carcinoid (PC). This study aimed to retrospectively compare the F-FDG PET/CT features of PC subtypes and observe clinicopathological and oncogenic characteristics of PC.
We performed a retrospective review in 60 patients with PC, from January 2016 to November 2021, who underwent the F-FDG PET/CT scan. All the PC diagnoses were histopathologic confirmed by surgical samples. The metabolic and morphological features were obtained from F-FDG PET/CT images. The ratio of metabolic to morphological lesion volumes (MMVR) was calculated.
Sixty patients with PC were consecutively identified, including 39 patients (65.0%) with typical carcinoids (TCs) and 21 (35.0%) with atypical carcinoids (ACs). One (1/21) patient had mutation in BRAF. The ACs have a larger size ( < 0.001), more metastatic lymph nodes ( = 0.011), higher Ki-67 expression ( < 0.001), higher SUVmax values ( = 0.003), higher SUVmean values ( = 0.006), higher SULmax values ( = 0.005), higher SUVbsa values ( = 0.001), higher MTV values ( = 0.033), and higher TLG values ( = 0.002). The multivariate analysis showed that MMVR ( = 0.020) was significantly associated with AC. For predicting AC, the optimal cut-off value of SUVmax, SUVmean, SULmax, SUVbsa, MTV, TLG, and the maximum diameter was 5.19, 3.18, 2.65, 1.47, 4.36, 18.44, and 3.0, respectively. The AUC values of above mentioned parameters was 0.756 (95%CI, 0.631-881; = 0.001), 0.735 (95%CI, 0.602-868; = 0.003), 0.736 (95%CI, 0.607-865; = 0.003), 0.742 (95%CI, 0.612-873; = 0.002), 0.593 (95%CI, 0.430-755; = 0.239), 0.680 (95%CI, 0.531-829; = 0.022), and 0.733 (95%CI, 0.598-868; = 0.003), respectively. For predicting TC, the optimal cut-off value of the MMVR was 0.92, and the AUC value was 0.780 (95%CI, 0.647-0.913; < 0.001).
F-FDG PET/CT can simultaneously reveal the metabolic and morphological characteristics of PC, which is important in the differentiation for histopathologic subtypes.
代谢参数包括平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）、最大标准化摄取值瘦体重（SULmax）和最大标准化摄取值体表面积（SUVbsa），在肺类癌（PC）中很少被研究。本研究旨在回顾性比较 PC 亚型的 F-FDG PET/CT 特征，并观察 PC 的临床病理和致癌特征。
我们对 2016 年 1 月至 2021 年 11 月期间接受 F-FDG PET/CT 扫描的 60 例经病理证实的 PC 患者进行了回顾性分析。所有 PC 诊断均经手术标本的组织病理学证实。代谢和形态特征从 F-FDG PET/CT 图像中获得。计算代谢与形态病变体积比（MMVR）。
连续鉴定出 60 例 PC 患者，包括 39 例典型类癌（TCs）（65.0%）和 21 例非典型类癌（ACs）（35.0%）。1 例（1/21）患者存在 BRAF 突变。AC 肿瘤的体积更大（ < 0.001），转移淋巴结更多（ = 0.011），Ki-67 表达更高（ < 0.001），SUVmax 值更高（ = 0.003），SUVmean 值更高（ = 0.006），SULmax 值更高（ = 0.005），SUVbsa 值更高（ = 0.001），MTV 值更高（ = 0.033），TLG 值更高（ = 0.002）。多变量分析显示 MMVR（ = 0.020）与 AC 显著相关。对于预测 AC，SUVmax、SUVmean、SULmax、SUVbsa、MTV、TLG 和最大直径的最佳截断值分别为 5.19、3.18、2.65、1.47、4.36、18.44 和 3.0。上述参数的 AUC 值分别为 0.756（95%CI，0.631-881； = 0.001）、0.735（95%CI，0.602-868； = 0.003）、0.736（95%CI，0.607-865； = 0.003）、0.742（95%CI，0.612-873； = 0.002）、0.593（95%CI，0.430-755； = 0.239）、0.680（95%CI，0.531-829； = 0.022）和 0.733（95%CI，0.598-868； = 0.003）。对于预测 TC，MMVR 的最佳截断值为 0.92，AUC 值为 0.780（95%CI，0.647-0.913； < 0.001）。
F-FDG PET/CT 可以同时显示 PC 的代谢和形态特征，这对于组织病理学亚型的鉴别很重要。
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