Pigmented Villonodular Synovitis Potential Pitfall on Oncologic 18F-FDG PET/CT
Pigmented Villonodular Synovitis Potential Pitfall on Oncologic 18F-FDG PET/CT
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DOI：
10.1097/rlu.0000000000000893
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发表时间：
2016-01-01
影响因子：
10.6
通讯作者：
Wenger, Doris E.
中科院分区：
文献类型：
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作者：
Broski, Stephen M.;Murdoch, Nathan M.;Wenger, Doris E.
目的 本研究评估了 F-18-FDG PET/CT 上色素沉着绒毛结节性滑膜炎 (PVNS) 和腱鞘巨细胞瘤 (GCTTS) 的半定量和定性外观。 患者和方法 对 2003 年至 2013 年期间接受 PET/CT 诊断为 GCTTS、局灶性 PVNS 或弥漫性 PVNS 的患者进行了机构审查委员会批准的回顾性审查。在所有可用的 PET/CT 上确定每个病变的肝脏 SUVmax/SUVmean (SUVr)。审查了相关常规影像学和患者记录。结果 确定了 14 名患者（平均 [SD] 年龄，52.8 [14.0] 岁；范围，26-74 岁），其中 6 名患者接受过 2 次或以上 PET/CT 检查。所有病变的平均 (SD) SUVmax 和 SUVr 分别为 8.7（3.4；范围，4.0-14.5）和 3.9（1.7；范围，2.0-7.1）。局灶性 PVNS (6.8 [3.0], 3.3 [1.9])、GCTTS (9.1 [3.0], 4.0 [1.2]) 或弥漫性 PVNS (14.5, 7.1) 亚型之间的平均 (SD) SUVmax (P = 0.10) 或 SUVr (P = 0.11) 没有差异。在 6 名患者的 29 次比较 PET/CT 中，17 次是在非靶向化疗后进行的，12 次是在没有既往治疗的情况下进行的。 11例出现SUVr显着波动（>25%）； SUVr 变化与是否进行化疗之间不存在相关性。 结论 色素沉着绒毛结节性滑膜炎和 GCTTS 可能呈强烈代谢亢进，在 F-18-FDG PET/CT 上类似于肌肉骨骼转移。无论是在非靶向化疗期间还是在治疗之间，它们都可能有显着的 SUV 波动。对于局灶性关节内或关节旁 FDG 强烈病变，应考虑 PVNS/GCTTS 的诊断，考虑到这种方式的常见诊断影像特征，MRI 可用于进一步评估。
Purpose This study evaluated the semiquantitative and qualitative appearance of pigmented villonodular synovitis (PVNS) and giant cell tumor of the tendon sheath (GCTTS) on F-18-FDG PET/CT.Patients and Methods An institutional review board-approved retrospective review was performed for patients diagnosed with GCTTS, focal PVNS, or diffuse PVNS who underwent PET/CT from 2003 to 2013. SUVmax and SUVmax/SUVmean of the liver (SUVr) were determined for each lesion on all available PET/CTs. Relevant conventional imaging and patient records were reviewed.Results Fourteen patients (mean [SD] age, 52.8 [14.0] years; range, 26-74 years) were identified, 6 with 2 or more PET/CT examinations. The mean (SD) SUVmax and SUVr of all lesions were 8.7 (3.4; range, 4.0-14.5) and 3.9 (1.7; range, 2.0-7.1), respectively. There was no difference of the mean (SD) SUVmax (P = 0.10) or SUVr (P = 0.11) between focal PVNS (6.8 [3.0], 3.3 [1.9]), GCTTS (9.1 [3.0], 4.0 [1.2]), or diffuse PVNS (14.5, 7.1) subtypes. Of 29 comparison PET/CTs in 6 patients, 17 were performed after nontargeted chemotherapy and 12 without antecedent therapy. Significant SUVr fluctuations (>25%) occurred in 11 cases; no correlation existed between SUVr change and presence or absence of chemotherapy.Conclusions Pigmented villonodular synovitis and GCTTS can be intensely hypermetabolic, mimicking musculoskeletal metastases on F-18-FDG PET/CT. They may have significant SUV fluctuations, both during nontargeted chemotherapy and between treatments. The diagnosis of PVNS/GCTTS should be considered for focal intra-articular or juxta-articular FDG-avid lesions, and MRI is useful in further evaluation given the often diagnostic imaging features with this modality.