Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland
Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland
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18F-FDG PET/CT 鉴别腮腺局灶性高代谢病变良恶性的诊断标准
DOI：
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发表时间：
2012
影响因子：
1.3
通讯作者：
Byung‐Tae Kim
中科院分区：
文献类型：
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作者：
Soo Bin Park;J. Choi;E. Lee;Jang Yoo;Miju Cheon;S. Cho;Y. Choe;Kyung;Byung‐Tae Kim
目的探讨腮腺局灶性18F-FDG摄取PET/CT鉴别腮腺良恶性病变的诊断标准。研究对象为67例患者的68个腮腺病变。将每个腮腺病变在PET/CT图像上的最大SUV(SUVmax)、摄取方式(均匀与不均匀)、大小、最大Hounsfield单位(Humax)和CT边缘(清晰与不清晰)与最终诊断进行比较。良、恶性病变在CT上的摄取方式(癌发生率，异质性：均质性 = 为79.2%：29.5%，p 和lt； 为0.0001)和边缘(癌发生率，疾病：清晰 = 为84.4%：13.3%，p 和lt； 为0.0001)有显著差异。腮腺病变的癌变风险为89.5%，其中89.5%为不均匀摄取和边界不清，70.6%为摄取不均匀或边界不清(受试者无重叠)，9.3%为均匀摄取和边界不清(p <； 0.0001)。以病灶形态不均匀或边界不清为恶性时，其敏感性为90.6%(29/32)，特异性为80.6%(29/36)，阳性预测值为80.6%(29/36)，阴性预测值为90.6%(29/32)，准确度为85.6%(58/68)。对于恶性肿瘤的预测，PET/CT联合标准显示出比仅PET标准更高的灵敏度、NPV和准确性，并且有比仅CT标准更准确的结果的趋势。结论CT摄取方式和边缘是鉴别良恶性病变的有用的PET/CT诊断指标。
PurposeWe investigated PET/CT diagnostic criteria for differentiating benign from malignant parotid lesions with focal 18F-FDG uptake.MethodsThe subjects of the study were 272 patients who exhibited focal 18F-FDG uptake of the parotid gland. Sixty-eight pathologically confirmed parotid lesions from 67 patients were included. The maximum SUV (SUVmax), uptake patterns (homogeneous vs. heterogeneous), size measured by CT, maximum Hounsfield units (HUmax) and margins on CT (well vs. ill defined) of each parotid lesion on PET/CT images were compared with final diagnoses.ResultsThirty-two parotid lesions were histologically proven to be malignant. There were significant differences in uptake patterns (cancer incidence, heterogeneous:homogeneous = 79.2%:29.5%, p < 0.0001) and margins on CT (cancer incidence, ill:well defined = 84.4%:13.3%, p < 0.0001) between benign and malignant lesions. The cancer risks of parotid lesions were 89.5% with heterogeneous uptake and ill-defined margins, 70.6% with heterogeneous uptake or ill-defined margins (no overlap in subjects) and 9.3% with homogeneous uptake and well-defined margins (p < 0.0001). When any lesion with heterogeneous uptake or ill-defined margins was regarded as malignant, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.6% (29/32), 80.6% (29/36), 80.6% (29/36), 90.6% (29/32) and 85.6% (58/68), respectively. For predicting malignancy, combined PET/CT criteria showed better sensitivity, NPV and accuracy than PET-only criteria, and had a tendency to have more accurate results than CT-only criteria. There were no significant differences in SUVmax, size or HUmax between benign and malignant lesions.ConclusionUptake patterns and margins on CT are useful PET/CT diagnostic criteria for differentiating benign from malignant lesions.