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KMID : 1148920110450030006
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Nuclear Medicine and Molecular Imaging
2011 Volume.45 No. 3 p.6 ~ p.6
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The Clinical Usefulness of 18F-FDG PET/CT in Patients with Systemic Autoimmune Disease
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Oh Jong-Ryool
Song Ho-Chun
Kang Sae-Ryung
Yoo Su-Woong
Kim Ja-Hae
Chong A-Ri
Min Jung-Joon
Bom Hee-Seung
Lee Shin-Seok
Park Yong-Wook
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Abstract
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Purpose: Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of 18F-FDG PET/CT in patients with systemic autoimmune disease.
Methods: Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs.
Results: FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC?=?1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P?=?0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P?=?0.040).
Conclusions: PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false-positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.
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KEYWORD
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Autoimmune disease, PET/CT, Neoplasms, Tuberculosis, Reactive lymphoid hyperplasia
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