Comparison of imaging features of 18F-FDG PET/CT in malignant pleural effusion and tuberculosis pleural effusion / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the imaging features of 18F-FDG PET/CT in malignant pleural effusion (MPE) and tuberculosis pleural effusion (TPE).Methods From January 2012 to December 2014,93 patients (52 males,41 females,and average age (66.7±12.7) years) with unexplained pleural effusion who underwent 18F-FDG PET/CT were retrospectively studied.MPE and TPE were confirmed by histology,cytology or clinical follow-up.Lesion SUVmax and T/NT were calculated.Both lesion size and density (in Hounsfield units) of pleural abnormalities on CT images were measured.The difference of images between MPE and TPE was analyzed.Diagnostic efficiency of 18F-FDG PET/CT for detecting MPE and TPE were estimated.Two-sample t test and x2 test were used to analyze the data.Results The lesion SUVmax of 66 patients with MPE and 27 patients with TPE was higher than that in normal tissues (7.72±6.50,8.43±4.92;t=7.81 and 7.15,both P＜0.01),but there was no statistical difference between the TPE and MPE (t=0.56,P＞0.05).T/NT was not significantly different between MPE and TPE (5.40±4.29,5.20±2.73 respectively,t=-0.22,P＞0.05) either.The uptake features of 18F-FDG were different between MPE and TPE (x2=29.3,P＜0.01).When the nodular 18F-FDG uptake increase in pleura was taken as the malignancy,diffuse 18F-FDG uptake increase in pleura as tuberculosis,the sensitivity,specificity,positive predictive value,and negative predictive value of 18F-FDG PET/CT were 78.8％ (52/66),81.5％ (22/27),91.2％ (52/57),61.1％ (22/36),respectively,for differentiation of MPE from TPE.Primary cancers were found in 43 patients.When the nodular uptake increase in pleura,or primary cancer associated with increased pleural uptake found by PET was taken as the malignancy,the above mentioned parameters were95.5％(63/66),81.5％(22/27),92.6％(63/68),88.0％(22/25),respectively.Conclusions The 18FFDG uptake in MPE and TPE is higher than that in normal tissues.18F-FDG PET/CT is helpful in the search for the primary tumor of MPE.Qualitative method of 18F-FDG PET/CT has a good value in the differentiation of MPE from TPE.