Skeletal Muscle Metastases on FDG PET/CT Imaging
Skeletal Muscle Metastases on FDG PET/CT Imaging
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DOI：
10.1097/rlu.0b013e3182443e32
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发表时间：
2012-06-01
影响因子：
10.6
通讯作者：
Ravi, Ajay
中科院分区：
文献类型：
--
作者：
Khandelwal, Alok R.;Takalkar, Amol M.;Ravi, Ajay
背景：尽管骨骼肌占体重的 50% 以上，但骨骼肌转移 (SMM) 的情况很少见。当存在时，大多数是无症状的，通常是在影像学检查中偶然发现的。多项研究报告了 SMM 患者的孤立病例。我们研究的目的是对接受全身 FDG PET/CT 成像检查的恶性肿瘤患者 SMM 的发病率、频率和来源进行全面的回顾性分析。方法：回顾了 2006 年 1 月至 2009 年 12 月期间在我们机构转诊进行肿瘤成像的 8492 名连续患者的记录。对 FDG PET 成像显示 SMM 的患者进行了进一步评估，以获取其他成像方式、组织取样病理学和后续扫描的合作证据。我们计算了我们环境中 SMM 的发病率，并评估了它们与各种原发性恶性肿瘤的关联。结果：PET/CT 成像总共识别出 73 名 SMM 患者（发病率为 0.86%）。肺癌是最常见的来源（25名患者[34%]），其次是胃肠道恶性肿瘤（13名患者[18%]）、乳腺癌（10名患者[14%]）、泌尿生殖系统恶性肿瘤和淋巴瘤（各6名患者[8%]）、黑色素瘤（5名患者[7%]）和其他杂项恶性肿瘤（3名患者[4%]）。仅 5 名患者 (7%) 的主要来源仍不清楚。大多数 SMM 患者通常有明显广泛的受累，导致 FDG PET/CT 成像出现异常。然而，由于这些患者大多数由于其他地方的内脏转移而患有IV期恶性疾病，因此他们通常不会被抢先分期。结论：我们的研究证实了SMM的罕见发生。此外，FDG PET/CT 还可以检测出未被怀疑的 SMM。有趣的是，在我们的患者群体中，肺癌被发现是最常见的骨骼肌转移恶性肿瘤。了解广泛存在的 SMM 的存在和外观可能有助于正确解释 FDG PET/CT 扫描。
Background: Skeletal muscle metastases (SMM) are a rare occurrence despite the fact that skeletal muscle comprises more than 50% of total body mass. When present, most are asymptomatic and are often found incidentally on imaging. Several studies have reported isolated cases of patients with SMM. The goal of our study was to perform a comprehensive retrospective analysis of the incidence, frequency, and source of SMM in patients with malignancies who underwent whole-body FDG PET/CT imaging for the workup for their malignancy.Methods: The records of 8492 consecutive patients referred for oncologic imaging at our institution during the period from January 2006 to December 2009 were reviewed. Patients who had SMM on FDG PET imaging were further assessed for collaborating evidence on other imaging modalities, pathology from tissue sampling, and follow-up scans. The incidence of SMM in our setting was calculated, and their association with various primary malignancies was also evaluated.Results: A total of 73 patients with SMM were identified on PET/CT imaging (incidence, 0.86%). Lung cancer was the most frequent source (25 patients [34%]), followed by gastrointestinal tract malignancies (13 patients [18%]), breast cancer (10 patients [14%]), genitourinary malignancies and lymphoma (6 patients [8%] each), melanoma (5 patients [7%]), and other miscellaneous malignancies (3 patients [4%]). Primary source remained unknown in only 5 patients (7%). Most patients with SMM generally had markedly widespread involvement which led to an unusual appearance on FDG PET/CT imaging. However, since most of these patients had stage IV malignant disease by virtue of visceral metastases elsewhere as well, they were generally not upstaged.Conclusions: Our study confirmed the rare occurrence of SMM. Furthermore, FDG PET/CT can potentially detect unsuspected SMM. Interestingly, in our patient population, lung cancer was found to be the most frequent malignancy metastasizing to the skeletal muscles. Knowledge about the presence and appearance of widespread SMM may aid in appropriate interpretation of FDG PET/CT scans.