Tatcı Ebru, Özmen Özlem, Kızılgöz Derya, Demirağ Funda, Bilgiç Seçkin
Ankara Atatürk Sanatorium Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Türkiye.
Ankara Atatürk Sanatorium Training and Research Hospital, Clinic of Pulmonology, Ankara, Türkiye.
Mol Imaging Radionucl Ther. 2024 Oct 7;33(3):147-155. doi: 10.4274/mirt.galenos.2024.24571.
The purpose of this study was to investigate whether F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) parameters have a role in differentiating invasive mucinous lung adenocarcinoma (IMA) from lepidic predominant lung adenocarcinoma (LPA). Additionally, we compared the F-FDG-PET/CT features between survivors and non-survivors.
Tumors were divided into 2 groups according to CT appearance: Group 1: nodular-type tumor; group 2: mass- or pneumonic-type tumor. Unilateral and bilateral multifocal diseases were detected. Clinicopathological characteristics and PET/CT findings were compared between IMAs and LPAs, as well as between survivors and non-survivors.
We included 43 patients with IMA and 14 with LPA. Tumor size (p=0.003), incidence of mass/pneumonic type (p=0.011), and bilateral lung involvement (p=0.049) were higher in IMAs than in LPAs. IMAs had more advanced T, M, and Tumor, Node, and Metastasis stages than in LPAs (p=0.048, p=0.049, and p=0.022, respectively). There was no statistically significant difference in maximum standardized uptake value (SUV) between the IMA and LPA (p=0.078). The SUV was significantly lower in the nodular group than in the mass/pneumonic-type group (p=0.0001). A total of 11 patients died, of whom SUV values were significantly higher in these patients (p=0.031). Male gender (p=0.0001), rate of stage III-IV (p=0.0001), T3-T4 (p=0.021), M1 stages (p=0.0001), multifocality (p=0.0001), and bilateral lung involvement (p=0.0001) were higher in non-survivor.
Although CT images were useful for the differential diagnosis of LPAs and IMAs, SUV was not helpful for differentiation of these 2 groups. However, both F-FDG uptake and CT findings may play an important role in predicting prognosis in these patients.
本研究旨在探讨¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）参数在鉴别浸润性黏液性肺腺癌（IMA）与鳞屑状为主型肺腺癌（LPA）方面是否具有作用。此外，我们比较了幸存者与非幸存者之间的¹⁸F-FDG-PET/CT特征。
根据CT表现将肿瘤分为2组：第1组：结节型肿瘤；第2组：肿块型或肺炎型肿瘤。检测到单侧和双侧多灶性病变。比较IMA与LPA之间以及幸存者与非幸存者之间的临床病理特征和PET/CT表现。
我们纳入了43例IMA患者和14例LPA患者。IMA的肿瘤大小（p = 0.003）、肿块/肺炎型发生率（p = 0.011）和双侧肺受累情况（p = 0.049）高于LPA。IMA的T、M以及肿瘤、淋巴结和转移分期比LPA更高级（分别为p = 0.048、p = 0.049和p = 0.022）。IMA与LPA之间的最大标准化摄取值（SUV）无统计学显著差异（p = 0.078）。结节组的SUV显著低于肿块/肺炎型组（p = 0.0001）。共有11例患者死亡，这些患者的SUV值显著更高（p = 0.031）。非幸存者的男性性别（p = 0.0001）、III-IV期比例（p = 0.0001）、T3-T4（p = 0.021）、M1期（p = 0.0001）、多灶性（p = 0.0001）和双侧肺受累情况（p = 0.0001）更高。
尽管CT图像对LPA和IMA的鉴别诊断有用，但SUV对这两组的鉴别并无帮助。然而，¹⁸F-FDG摄取和CT表现可能在预测这些患者的预后中发挥重要作用。
