Dual time-point 18F-FDG PET/CT imaging with multiple metabolic parameters in the differential diagnosis of malignancy-suspected bone/joint lesions.

Chen-Tian Shen,Zhong-Ling Qiu,Xin-Yun Zhang,Quan-Yong Luo,Wei-Jun Wei,Zhen-Kui Sun,Hong-Jun Song

doi:10.18632/oncotarget.17140

Chen-Tian Shen, Zhong-Ling Qiu + Show 5 more

Open Access

https://doi.org/10.18632/oncotarget.17140

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Journal: Oncotarget	Publication Date: Apr 17, 2017
Citations: 5	License type: cc-by

Affiliation: Shanghai Jiao Tong University

Abstract

The purpose of this study was to evaluate the diagnostic potential of dual time-point18F-FDG PET/CT imaging with multiple metabolic parameters in malignancy-suspected bone/joint lesions. Fifty seven consecutive patients were recruited. PET parameters including SUVmax, SUVmean, metabolic tumor volume (MTV), total lesional glycolysis (TLG) and retention indexes (RIs) were obtained. Thirty five malignant and 22 benign lesions were confirmed by pathology. In all, 48 receiver operating characteristic (ROC) curves were derived. For SUVmax, MTV2.0, TLG2.0, MTV2.5 and TLG2.5, areas under the curves (AUCs) of early time-point imaging were similar to those of delayed time (P > 0.05), while higher than those of dual time (P< 0.05). For MTV50%max, TLG50%max, MTV75%max and TLG75%max, AUCs of early time-point imaging were lower than those of delayed time (P< 0.05), while similar to those of dual time (P> 0.05). In conclusion, dual time-point18F-FDG PET/CT imaging shows limited value in the differential diagnosis of malignancy-suspected bone/joint lesions. However, MTV and TLG at a fixed SUV threshold (50% or 75% of SUVmax) in delayed time-point imaging may provide better diagnostic accuracy

Highlights

Skeletal sarcoma is a relatively rare and heterogeneous tumor group
In the current study, we evaluated the diagnostic potentials of dual time-point 18F-FDG PET/computer tomography (CT) imaging with parameters including maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesional glycolysis (TLG) in malignancy-suspected bone/joint lesions
48 receiver operating characteristic (ROC) curves from 16 parameters in respective early, delayed and dual time-point imaging were analyzed with their respective areas under the curve (AUC), sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood radio (NLR)

Summary

Introduction

Skeletal sarcoma is a relatively rare and heterogeneous tumor group. most common causes of cancer death are cancers of the lung and bronchus, prostate, breast and colorectum, primary malignancy of the bone/joint is ranked as the third leading cause of death in patients with cancer who are younger than 20 years [1]. By providing important information like the appearance, intraosseous extent and internal characteristics of intraosseous lesions, radiographs (including X-ray and computer tomography [CT]) and magnetic resonance imaging (MRI) are of great importance in the clinical evaluation of skeletal diseases [2]. It has been used to differentiate malignant and benign diseases including skeletal lesions [4]. The uptake of FDG by malignant tumor cells is generally higher than by benign ones, quantities of exceptions do exist in 18F-FDG PET/CT imaging. Multiple studies have shown that dual time-point imaging (DTPI) of 18F-FDG PET/CT could enhance the diagnostic accuracy and retention index (RI) of the maximum standardized uptake value (SUVmax) is the most commonly used PET metabolic parameter in DTPI [5,6,7]. Few series reported the quantitative analysis of dual time-point and/

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