Zhang Hui, Pang Lifang, Hou Jun, Li Beilei, Zhang Yiqiu
Department of Nuclear Medicine, Zhongshan Hospital (Xiamen), Fudan University, Fujian.
Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Fujian.
Nucl Med Commun. 2025 Aug 1;46(8):746-752. doi: 10.1097/MNM.0000000000001990. Epub 2025 May 6.
This study was aimed at evaluating the significance of 18 F-fluorodeoxyglucose PET/computed tomography (FDG PET/CT) in the staging and differentiation of malignant peritoneal mesothelioma (MPeM).
We retrospectively analyzed clinical and imaging data of 21 women and 21 men with MPeM who underwent 18 F-FDG PET/CT, and reviewed and analyzed 18 F-FDG PET/CT characteristics of the patients. Standardized uptake values (SUV max ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG = MTV × SUV mean ) were determined for peritoneal lesions at the highest glycolysis point. Two experienced readers assessed tumor-node-metastasis (TNM) staging and peritoneal cancer index according to Peritoneal Surface Oncology Group International diagnostic requirements.
The SUV max and MTV values were significantly lower for the epithelial cases than for the nonepithelioid cases, with the difference being significant ( P < 0.05). The mean TLG value was significantly lower for the epithelial cases than for the nonepithelioid cases; however, the difference was NS ( P > 0.05). Exploratory laparotomy was performed in 18 patients, the 18 F-FDG PET/CT diagnostic accuracy for the T stage was 72.2%, and the TNM stage diagnostic accuracy was 94.4%. However, lymph node metastasis was more common in the biphasic type group, and metastasis was more often seen in the sarcomatoid type group.
Using a previously suggested novel approach for TNM staging in 18 F-FDG PET/CT assessment of MPeM may improve the accuracy of staging; however, SUV max values showed slight variations depending on the pathology type. 18 F-FDG PET/CT can improve the accuracy of TNM staging, and SUV max values vary slightly depending on the pathology type. Furthermore, 18 F-FDG PET/CT can afford simultaneous visualization of lesions throughout the body, which can help develop a treatment strategy.
本研究旨在评估18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）在恶性腹膜间皮瘤（MPeM）分期及鉴别诊断中的意义。
我们回顾性分析了21例女性和21例男性MPeM患者接受18F-FDG PET/CT检查的临床及影像资料，并对患者的18F-FDG PET/CT特征进行回顾性分析。在糖酵解最高的点测定腹膜病变的标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG = MTV×SUVmean）。两名经验丰富的阅片者根据国际腹膜表面肿瘤学组的诊断要求评估肿瘤-淋巴结-转移（TNM）分期和腹膜癌指数。
上皮型病例的SUVmax和MTV值显著低于非上皮样型病例，差异有统计学意义（P < 0.05）。上皮型病例的平均TLG值显著低于非上皮样型病例；然而，差异无统计学意义（P > 0.05）。18例患者接受了剖腹探查术，18F-FDG PET/CT对T分期的诊断准确率为72.2%，TNM分期诊断准确率为94.4%。然而，双相型组淋巴结转移更常见，肉瘤样型组转移更常见。
在18F-FDG PET/CT评估MPeM时，采用先前建议的TNM分期新方法可能提高分期的准确性；然而，SUVmax值因病理类型而异。18F-FDG PET/CT可提高TNM分期的准确性，且SUVmax值因病理类型略有不同。此外，18F-FDG PET/CT能够同时显示全身病变，有助于制定治疗策略。
