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Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and 18F-FDG PET/CT in Correlation with Clinical Pathologic Outcome.

肺淋巴管癌病: 高分辨率 CT 和 18F-FDG PET/CT 的诊断性能与临床病理结果的相关性。

  • 影响因子:5.06
  • DOI:10.2967/jnumed.119.229575
  • 作者列表:"Jreige M","Dunet V","Letovanec I","Prior JO","Meuli RA","Beigelman-Aubry C","Schaefer N
  • 发表时间:2020-01-01
Abstract

:The rationale of this study was to investigate the performance of high-resolution CT (HRCT) versus 18F-FDG PET/CT for the diagnosis of pulmonary lymphangitic carcinomatosis (PLC). Methods: In this retrospective institution-approved study, 94 patients addressed for initial staging of lung cancer with suspicion of PLC were included. Using double-blind analysis, we assessed the presence of signs favoring PLC on HRCT (smooth or nodular septal lines, subpleural nodularity, peribronchovascular thickening, satellite nodules, lymph node enlargement, and pleural effusion). 18F-FDG PET/CT images were reviewed to qualitatively evaluate peritumoral uptake and to quantify tracer uptake in the tumoral and peritumoral areas. Histology performed on surgical specimens served as the gold standard for all patients. Results: Among 94 included patients, 73% (69/94) had histologically confirmed PLC. Peribronchovascular thickening, lymph node involvement, and increased peritumoral uptake were more often present in patients with PLC (P < 0.009). Metabolic variables, including tumor SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis, as well as peritumoral SUVmax, SUVmean, and their respective ratios to background, were significantly higher in the PLC group than in the non-PLC group (P ≤ 0.0039). Sensitivity, specificity, and area under the receiver-operating-characteristic curve for peribronchovascular thickening (69%, 83%, and 0.76, respectively; 95% confidence interval [95%CI], 0.67-0.85) and increased peritumoral uptake (94%, 84%, and 0.89, respectively; 95%CI, 0.81-0.97) were similar (P = 0.054). For detecting PLC, sensitivity, specificity, and area under the receiver-operating-characteristic curve were significantly higher, at 97%, 92%, and 0.98, respectively (95%CI, 0.96-1.00), for peritumoral SUVmax and 94%, 88%, and 0.96, respectively (95%CI, 0.92-1.00), for peritumoral SUVmean (all P ≤ 0.025). Conclusion: Qualitative evaluation of 18F-FDG PET/CT and HRCT perform similarly for the diagnosis of PLC, with both being outperformed by 18F-FDG PET/CT quantitative parameters.

摘要

本研究的基本原理是探讨高分辨率 CT (HRCT) 与 18F-FDG PET/CT 诊断肺淋巴管癌病 (PLC) 的性能。方法: 在这项回顾性机构批准的研究中,纳入了 94 例疑似 PLC 的肺癌初始分期患者。采用双盲分析,我们评估了 HRCT 上支持 PLC 的征象 (光滑或结节间隔线、胸膜下结节、支气管血管周围增厚、卫星结节、淋巴结肿大、和胸腔积液)。回顾 18F-FDG PET/CT 图像,定性评价瘤周摄取,定量肿瘤和瘤周区域的示踪剂摄取。对手术标本进行的组织学检查作为所有患者的金标准。结果: 在纳入的 94 例患者中,73% 例 (69/94) 有组织学证实的 PLC。PLC 患者支气管血管周围增厚、淋巴结受累和瘤周摄取增加更常见 (P <0.009)。代谢变量,包括肿瘤 SUVmax 、 SUVmean 、代谢肿瘤体积和总病变糖酵解,以及瘤周 SUVmax 、 SUVmean 及其各自与背景的比值,PLC 组显著高于非 PLC 组 (P ≤ 0.0039)。支气管血管周围增厚的敏感性、特异性和接受者操作特征曲线下面积 (分别为 69% 、 83% 和 0.76; 95% 置信区间 [95% CI],0.67-0.85) 瘤周摄取增加 (分别为 94% 、 84% 和 0.89; 95% CI,0.81-0.97) 相似 (P = 0.054)。对于检测 PLC,灵敏度、特异度和受试者工作特征曲线下面积显著较高,分别为 97% 、 92% 和 0.98 (95% CI, 0.96-1.00),对于瘤周 SUVmax 和 94% 、 88% 和 0.96 (95% CI,0.92-1.00),对于瘤周 SUVmean (所有 P ≤ 0.025)。结论: 18F-FDG PET/CT 和 HRCT 对 PLC 的定性诊断价值相似,两者均优于 18F-FDG PET/CT 定量参数。

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影响因子:1.84
发表时间:2020-01-01
来源期刊:Oncology letters
DOI:10.3892/ol.2019.11149
作者列表:["Das SK","Huang YY","Li B","Yu XX","Xiao RH","Yang HF"]

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影响因子:8.44
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DOI:10.1016/j.annonc.2019.10.022
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