Role of multi-modality functional imaging in differentiation between benign and malignant thyroid 18F-fluorodeoxyglucose incidentaloma
Role of multi-modality functional imaging in differentiation between benign and malignant thyroid 18F-fluorodeoxyglucose incidentaloma
复制标题
多模态功能成像在甲状腺18F-氟脱氧葡萄糖偶发瘤良恶性鉴别中的作用
DOI：
10.1007/s12094-019-02089-9
复制
发表时间：
2019
影响因子：
3.4
通讯作者：
X. Ye
中科院分区：
文献类型：
--
作者：
H. Shi;Z. Yuan;C. Yang;J. Zhang;C. Liu;J. Sun;X. Ye
目的评价多模态功能成像在鉴别恶性和良性甲状腺18F-氟脱氧葡萄糖(18F-FDG)偶发瘤中的诊断性能。方法本研究纳入87例经18F-FDG-正电子发射断层扫描/计算机断层扫描(18F-FDG-PET/CT)检测并在手术或活检中确诊的甲状腺18F-FDG偶发瘤患者。接受 18 F-FDG-PET/CT、弥散加权 MR 成像 (DWI) 和超声弹性成像 (USE)。测量并比较良恶性甲状腺偶发瘤的代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）、表观扩散系数（ADC）值和甲状腺18F-FDG偶发瘤的超声弹性评分。恶性和良性甲状腺偶发瘤的差异采用χ2检验、Fisher精确检验、t检验或Mann-WhitneyU检验。通过受试者工作特征曲线分析评价甲状腺偶发瘤的诊断性能并确定区分恶性与良性偶发瘤的最佳临界值。结果甲状腺恶性偶发瘤的MTV、TLG和USE评分均显着高于良性；但ADC值明显降低。我们将功能影像参数TLG < 2.48、ADC > 1.80 × 10−3mm2/s、USE评分1作为甲状腺良性偶发瘤的标志物，每项得分-1分； TLG ≥ 2.48、ADC ≤ 1.80 × 10−3mm2/s、USE评分为4作为恶性标志，各得1分。组合多功能成像参数在区分恶性与良性甲状腺偶发瘤方面取得了最高性能（84.6%的敏感性和97.1%的特异性），AUC为0.957（95% CI 0.917，0.997）。结论功能成像可能有助于区分恶性与良性甲状腺18F-FDG偶发瘤，并且组合多功能成像参数可以改善它。
PurposeTo evaluate the diagnostic performance of multi-modality functional imaging in differentiating malignant and benign thyroid18F-fluorodeoxyglucose (18F-FDG) incidentaloma.MethodsThis study included 87 patients with thyroid18F-FDG incidentalomas detected by18F-FDG- positron emission tomography/computed tomography (18F-FDG-PET/CT) and diagnosed at surgery or biopsy, who received18F-FDG-PET/CT, diffusion-weighted MR imaging (DWI) and ultrasound elastography (USE). The metabolic tumor volume (MTV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) values and ultrasound elasticity scores of thyroid18F-FDG incidentalomas were measured and compared in benign and malignant thyroid incidentalomas. The differences of malignant and benign thyroid incidentalomas were tested byχ2test, Fisher’s exact test,ttest, or Mann–WhitneyUtest. The diagnostic performance was evaluated and optimal cut-off values were determined in distinguishing malignant from benign thyroid incidentalomas by receiver operating characteristic curve analysis.ResultsMTV, TLG and USE scores of malignant thyroid incidentalomas were significantly higher than benign; but ADC value was significantly lower. We defined the functional imaging parameters TLG < 2.48, ADC > 1.80 × 10−3mm2/s, and USE score of 1 as markers of benign thyroid incidentalomas and each scored -1 point; TLG ≥ 2.48, ADC ≤ 1.80 × 10−3mm2/s, and USE score of 4 as markers of malignancy and each scored 1 point. Combined multi-functional imaging parameters achieved the highest performance (84.6% sensitivity and 97.1% specificity) for distinguish malignant from benign thyroid incidentaloma with AUC 0.957 (95% CI 0.917, 0.997).ConclusionsFunctional imaging might help to distinguishing malignant from benign thyroid18F-FDG incidentalomas, and combined multi-functional imaging parameters could improve it.