Clinical Investigation
Clinical value of 18F-FDG PET/CT in distinguishing benign from malignant cardiac tumors
Meng Jingjing, Zhao Honglei, Lu Xia, Chen Dong, Wang Jianjie, Jiao Jian, Dong Wei, Zhu Ziwei, Xie Xiaofen, Li Junqi, Mi Hongzhi, Liu Yongmin, Zhang Xiaoli, Li Xiang
Published 2020-06-25
Cite as Chin J Nucl Med Mol Imaging, 2020, 40(6): 351-356. DOI: 10.3760/cma.j.cn321828-20190823-00180
Abstract
ObjectiveTo evaluate the clinical value of 18F-fluorodexoyglucose (FDG) PET/CT in distinguishing benign from malignant tumors in patients with cardiac tumors.
MethodsBetween January 2015 and September 2018, 18F-FDG PET/CT was performed in 3 678 patents in Beijing Anzhen Hospital, and 51 of them (51/3 678, 1.39%) were diagnosed as cardiac tumors. Finally, 28 patients (10 males, 18 females; mean age (52±14) years, age range: 18-84 years) with pathological results were included. According to pathological results, patients were divided into 4 groups: group 1 with primary benign cardiac tumor (n=9), group 2 with primary malignant cardiac tumor (n=9), group 3 with lymphoma (n=6) and group 4 with secondary malignant cardiac tumor (n=4). All patients underwent early (60 min) 18F-FDG PET/CT imaging and 22 patients (6, 7, 6, 3 patients in group 1, group 2, group 3, group 4 respectively) underwent delayed (120 min) imaging. The maximum standardized uptake value (SUVmax) and target/backgroud ratio (TBR) of 4 groups in early imaging and delayed imaging were calculated and compared with one-way analysis of viariace and Scheffe Post-hoc test. TBR were calcualted as SUVmax/mean standardized uptake value (SUVmean) in the liver. Receiver operating characteristic (ROC) curve analysis was also performed.
ResultsSUVmax during early imaging, defined SUVmax(early), was 2.6±1.5, 9.9±4.0, 20.5±6.1, 9.2±5.8 in group 1-4 respectively (F=21.39, P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (allP<0.005). TBRearly was 1.1±0.6, 4.1±1.6, 9.4±2.6, 3.7±2.0 in the 4 groups (F=29.15, P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (allP<0.005). SUVmax in delayed imaging (SUVmax(delay)) was 2.4±1.2, 11.0±5.9, 25.8±7.7, 13.7±7.7 respectively in the 4 groups (F=16.01, P<0.01). TBRdelay was also significantly different among the 4 groups (1.3±0.7, 5.5±2.9, 14.4±4.9, 7.9±5.0; F=14.78, P<0.01), the value of group 3 was higher than that of group 1 and 2 (allP<0.05). ROC curve analysis showed optimal cut-off values for indicating malignancy were: SUVmax(early)=4.2, TBRearly=1.6, SUVmax(delay)=4.6, TBRdelay=1.9. The corresponding sensitivities, specificities, accuracies were 19/19, 8/9, 96.4%(27/28); 19/19, 7/9, 92.9%(26/28); 16/16, 6/6, 100%(22/22); 16/16, 5/6, 95.5%(21/22), respectively.
Conclusions18F-FDG PET/CT imaging can accurately diagnose malignant cardiac tumors. Delayed imaging can further improve the accuracy for diagnosis of malignant cardiac tumors.
Key words:
Heart neoplasms; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Diagnosis, differential
Contributor Information
Meng Jingjing
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Zhao Honglei
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Lu Xia
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Chen Dong
Department of Pathology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Wang Jianjie
Departmentof Nuclear Medicine, the Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Jiao Jian
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Dong Wei
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Zhu Ziwei
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Xie Xiaofen
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Li Junqi
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Mi Hongzhi
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Liu Yongmin
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Zhang Xiaoli
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Li Xiang
Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
