Erasmus J J, Patz E F, McAdams H P, Murray J G, Herndon J, Coleman R E, Goodman P C
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
AJR Am J Roentgenol. 1997 May;168(5):1357-60. doi: 10.2214/ajr.168.5.9129444.
The purpose of this study was to assess the usefulness of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) when differentiating benign from metastatic adrenal masses in patients with bronchogenic carcinoma.
For our prospective study, any patient presenting to our institution with pathologically proven bronchogenic carcinoma and an adrenal mass was eligible. Thirty-three adrenal masses (mean size, 3 cm; range, 1-9 cm) in 27 patients were revealed by CT. PET was performed in all 27 patients and interpreted as positive when FDG uptake in the adrenal mass was greater than background activity or negative when FDG uptake in the adrenal mass was equal to or less than background activity. In addition, semiquantitative analysis was performed by computing a standardized uptake ratio. All studies were reviewed independently by three radiologists and then correlated with biopsy and CT findings. Specificity and sensitivity for determining metastatic disease to the adrenal gland were calculated.
FDG uptake was positive (abnormally increased) in 25 adrenal masses. Twenty-three (92%) of the 25 masses were metastatic disease. The mean standardized uptake ratio of these was 6.28 (range, 3.22-14.41). The remaining two masses (8%) that had positive FDG uptake showed no tumor at percutaneous biopsy. The standardized uptake ratio values for these two masses were 3.0 and 3.7. FDG uptake was negative (normal) in eight adrenal masses. All these lesions were benign as proven by biopsy (n = 2) and CT attenuation values of less than 10 H (n = 6). The mean standardized uptake ratio value for these eight lesions classified as benign was 1.77 (range, 0.93-3.70). The sensitivity for detecting metastatic disease was 100%, and the specificity was 80%.
PET with FDG is an accurate, noninvasive way to differentiate benign from metastatic adrenal masses in patients with bronchogenic carcinoma.
本研究旨在评估18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在鉴别支气管肺癌患者肾上腺肿块为良性或转移性方面的效用。
在我们的前瞻性研究中，任何病理证实为支气管肺癌且有肾上腺肿块的患者均符合条件。27例患者的33个肾上腺肿块（平均大小3 cm；范围1 - 9 cm）通过CT发现。所有27例患者均进行了PET检查，当肾上腺肿块的FDG摄取大于本底活性时判读为阳性，当肾上腺肿块的FDG摄取等于或小于本底活性时判读为阴性。此外，通过计算标准化摄取值进行半定量分析。所有研究均由三位放射科医生独立审查，然后与活检及CT结果进行对照。计算确定肾上腺转移瘤的特异性和敏感性。
25个肾上腺肿块的FDG摄取为阳性（异常增高）。这25个肿块中有23个（92%）为转移瘤。这些肿块的平均标准化摄取值为6.28（范围3.22 - 14.41）。其余两个FDG摄取为阳性的肿块经皮穿刺活检未发现肿瘤。这两个肿块的标准化摄取值分别为3.0和3.7。8个肾上腺肿块的FDG摄取为阴性（正常）。经活检（n = 2）及CT衰减值小于10 H（n = 6）证实，所有这些病变均为良性。这8个分类为良性的病变的平均标准化摄取值为1.77（范围0.93 - 3.70）。检测转移瘤的敏感性为100%，特异性为80%。
FDG PET是鉴别支气管肺癌患者肾上腺肿块为良性或转移性的一种准确、无创的方法。
