대한핵의학회지 (1967년~2009년)
대한핵의학회지 1997;31(1)90~12
원저 : FDG - PET을 이용한 악성과 양성 연부조직 병변의 감별 : 반정량적 지표간의 비교 ( The Differentiation of Benign from Malignant Soft Tissue Lesions using FDG - PET : Comparison between Semi - quantitative Indices )
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Author 최준영(Joon Young Choi), 이경한(Kyung Han Lee), 최용(Yearn Seong Choe), 최연성(Yong Choi), 김상은(Sang Eun Kim), 김병태(Byung Tae Kim),서재곤(Jai Gon Seo),
Affiliation
Abstract

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to- background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time- activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.

Keyword Soft tissue tumor; Positron emission tomography; Fluorine-18 FDG Standardized uptake value; Tumor-to-background ratio; Time-activity curve
Full text Article 28502005.pdf 28502005.pdf
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