Usefulness of positron emission tomography (PET)/contrast-enhanced computed tomography (CE-CT) in discriminating between malignant and benign intraductal papillary mucinous neoplasms (IPMNs)
Usefulness of positron emission tomography (PET)/contrast-enhanced computed tomography (CE-CT) in discriminating between malignant and benign intraductal papillary mucinous neoplasms (IPMNs)
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DOI：
10.1016/j.pan.2017.09.010
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发表时间：
2017-11-01
期刊：
影响因子：
3.6
通讯作者：
Iguchi, Haruo
中科院分区：
文献类型：
--
作者：
Ohta, Koji;Tanada, Minoru;Iguchi, Haruo
背景/目的：我们评估了正电子发射断层扫描(PET)/对比增强计算机断层扫描（CE-CT）在鉴别良性和恶性导管内乳头状粘液瘤（IPMNs）中的作用。方法：对29例IPMN病变行PET/CE-CT扫描，并行手术治疗。将术前PET/CE-CT检查结果与切除标本的组织学检查结果进行比较，以确定PET/CE-CT检查诊断IPMNs良恶性鉴别诊断的准确性。结果：29例IPMN病变中，良性9例，恶性20例。总体而言，20例恶性病例中有18例FDG摄取阳性，而9例良性病例中有7例FDG摄取阴性。FDG摄取作为良/恶性鉴别指标的敏感性、特异性和诊断准确性分别为90.0%、77.8%和86.2%。当使用基于指南的高危发现作为标记时，壁结节的敏感性、特异性和诊断准确性分别为50.0%、66.7%和55.2%，而主管扩张的敏感性、特异性和诊断准确性分别为40.0%、56%和48.3%。结论：PET检测FDG摄取可作为良恶性鉴别的新指标。由于PET/CE-CT成像是一种非侵入性成像方式，除了常规的高风险发现外，还可以评估FDG摄取，我们认为它应该是确定IPMN治疗方法的一线方法。（三）2017年IAP和EPC。Elsevier B.V.版权所有。
Background/Objectives: We evaluated the usefulness of positron emission tomography (PET)/contrast-enhanced computed tomography (CE-CT) in discriminating between malignant and benign intraductal papillary mucinous neoplasms (IPMNs).Methods: PET/CE-CT imaging was conducted on 29 IPMN lesions, which subsequently underwent surgery. Preoperative findings on PET/CE-CT imaging were compared with the histological findings of the resected specimens to determine the diagnostic accuracy of PET/CE-CT imaging for evaluation of the differential diagnosis between benign and malignant IPMNs.Results: The final diagnoses of the 29 IPMN lesions were 9 benign and 20 malignant. Overall, 18 of the 20 malignant cases were positive for FDG uptake, while 7 of 9 benign cases were negative. The sensitivity, specificity, and diagnostic accuracy for benign/malignant differentiation using FDG uptake as a marker were 90.0%, 77.8%, and 86.2%, respectively. When guideline-based high-risk findings were used as markers, sensitivity, specificity, and diagnostic accuracy for mural nodules were 50.0%, 66.7%, and 55.2%, while they were 40.0%, 56%, and 48.3% for main duct dilatation, respectively.Conclusions: FDG uptake on PET is a useful new marker for malignancy in benign/malignant differentiation. Because PET/CE-CT imaging is a noninvasive imaging modality that can evaluate FDG uptake in addition to the conventional high-risk findings, we believe it should be the first-line method for determining therapeutic approaches to IPMN. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.