Value of 18F-FDG PET/CT in differentiation of noninvasive and malignant pancreatic cystic lesions / 中华核医学与分子影像杂志

ABSTRACT

Objective@#To investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in differentiation of noninvasive and malignant pancreatic cystic lesions (PCL).@*Methods@#A total of 125 PCL patients (66 males, 59 females, age range 13-83 years), who had pathology or typical imaging performance with ≥12 months follow-up between August 2010 and December 2015, were enrolled in this retrospective study. The diagnostic effects of 18F-FDG PET/CT were calculated. The size, maximum standardized uptake value (SUVmax), delayed SUVmax and retention index (RI) of noninvasive and malignant PCL were analyzed. The results of pathological examination and follow-up were used as the gold standard, and Mann-Whitney u test was used to analyze the data. Receiver operating characteristic (ROC) curves of SUVmax, delayed SUVmax and RI were drawn and compared.@*Results@#A total of 132 PCL were found in 125 patients, including 71 malignant PCL and 61 noninvasive PCL. The size, SUVmax, delayed SUVmax, RI of noninvasive and malignant PLC were 2.2 (1.4, 3.8) cm vs 3.9 (3.0, 5.0) cm, 1.5 (1.2, 1.8) vs 6.4 (4.4, 9.3), 1.5 (1.2, 1.9) vs 6.4 (5.4, 11.7), -6.3%(-19.4%, 5.6%) vs 17.5%(7.6%, 29.4%), respectively. All parameters were significantly different between 2 groups (z values from -9.267 to -4.904, all P<0.05). The area under curve (AUC) and cut-off value of SUVmax were 0.969 and 2.5, and the corresponding accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 92.4%(122/132), 93.0%(66/71), 91.8%(56/61), 93.0%(66/71), 91.8%(56/61), respectively. The AUC and cut-off value of delayed SUVmax were 0.969 and 2.7, and the accuracy, sensitivity, specificity, PPV, NPV were 94.3%(99/105), 96.7%(58/60), 91.1%(41/45), 93.5%(58/62), 95.3%(41/43), respectively. ROC curves of SUVmax and delayed SUVmax were not significantly different (z=1.799, P>0.05).@*Conclusion@#18F-FDG PET/CT has good performance in differentiation of noninvasive and malignant PCL, but the delayed scan cannot further improve the efficacy of differential diagnosis.