The role of 18F-FDG PET/CT in the metabolic characterization of lung nodules in pediatric patients with bone sarcoma
The role of 18F-FDG PET/CT in the metabolic characterization of lung nodules in pediatric patients with bone sarcoma
复制标题
DOI：
10.1002/pbc.24242
复制
发表时间：
2012-12-01
影响因子：
3.2
通讯作者：
Fagioli, Franca
中科院分区：
文献类型：
--
作者：
Cistaro, Angela;Lopci, Egesta;Fagioli, Franca
本研究的主要目的是确定最小结节直径和SUVmax能够表征小儿骨肉瘤患者的肺结节。18例骨肉瘤患者（男/女=？11：7;平均年龄14岁），CT检查为可疑肺部病变。肺结节63个，平均直径3.35？mm（范围1.239.8？mm）进行了研究。根据标准程序使用混合PET/CT系统进行18F-FDG PET，并将结果与组织学和/或临床/放射学随访进行比较。对每个病灶，我们评估SUVmax、SUV与纵隔血池的比率和最大结节直径。结果63个结节中，良性32个，恶性31个。在视觉基础上，18F-FDG PET的准确性为88.9%，灵敏度为90.3%，特异性为87.5%，PPV为87.5%，NPV为90.3%。ROC曲线分析SUVmax值在1左右（>1.09）时，能区分转移瘤和良性病变，敏感性和特异性分别为90.3%和93.8%，准确性为92.1%。相似的分析显示，SUV比率的临界值约为1（>0.83）（敏感性和特异性分别为90.3%和90.6%），临界值约为0.83。六个？mm（>5.8？结节直径的敏感性和特异性分别为90.3%和81.3%。结论18F-FDGPET/CT是诊断小儿骨肉瘤肺结节代谢特征的一种准确方法，SUVmax（或SUVratio）>1能够鉴别良恶性病变。儿科血液癌症2012; 59：12061210。(C)2012 Wiley Periodicals，Inc.
Background The principal aim of this study was to identify the lowest nodule diameter and the SUVmax capable of characterizing lung nodules in pediatric patients with bone sarcoma. Procedure Eighteen consecutive bone sarcoma patients (M/F?=?11:7; mean age 14 years) with suspicious lung lesions at CT were enrolled. Overall, 63 lung nodules with a mean diameter of 3.35?mm (range 1.239.8?mm) were investigated. 18F-FDG PET was performed according to standard procedure using a hybrid PET/CT system and results were compared with histology and/or clinical/radiological follow-up. For each lesion, we evaluated SUVmax, SUVratio to the mediastinal blood pool and maximum nodule diameter. Results Of the 63 nodules, 32 proved to be benign and 31 malignant. On a visual basis, 18F-FDG PET had an accuracy of 88.9%, a sensitivity of 90.3%, a specificity of 87.5%, a PPV of 87.5%, and a NPV of 90.3%. ROC curve analysis of SUVmax for all nodules showed a value around 1 (>1.09) to be capable of differentiating metastases from benign lesions: sensitivity and specificity were 90.3% and 93.8%, respectively (accuracy 92.1%). Similar analysis revealed a cut-off value around 1 (>0.83) for SUVratio (sensitivity and specificity were 90.3% and 90.6%, respectively) and a cut-off value of ca. 6?mm (>5.8?mm) for nodule diameter (sensitivity and specificity of 90.3% and 81.3%, respectively). Conclusions 18F-FDG PET/CT is an accurate modality for the metabolic characterization of lung nodules in the pediatric population with bone sarcoma, and a SUVmax (or SUVratio) >1 is capable of discriminating malignant from benign lesions. Pediatr Blood Cancer 2012; 59: 12061210. (C) 2012 Wiley Periodicals, Inc.