Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and 18F-FDG PET/CT in Correlation with Clinical Pathologic Outcome

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_2665FFBF2930
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and 18F-FDG PET/CT in Correlation with Clinical Pathologic Outcome
Journal
Journal of Nuclear Medicine
Author(s)
Jreige Mario, Dunet Vincent, Letovanec Igor, Prior John O., Meuli Reto A., Beigelman-Aubry Catherine, Schaefer Niklaus
ISSN
0161-5505
2159-662X
ISSN-L
0161-5505
Publication state
Published
Issued date
11/2019
Peer-reviewed
Oui
Volume
61
Number
1
Pages
26-32
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The rationale of this study was to investigate the performance of high-resolution CT (HRCT) versus <sup>18</sup> F-FDG PET/CT for the diagnosis of pulmonary lymphangitic carcinomatosis (PLC). Methods: In this retrospective institution-approved study, 94 patients addressed for initial staging of lung cancer with suspicion of PLC were included. Using double-blind analysis, we assessed the presence of signs favoring PLC on HRCT (smooth or nodular septal lines, subpleural nodularity, peribronchovascular thickening, satellite nodules, lymph node enlargement, and pleural effusion). <sup>18</sup> F-FDG PET/CT images were reviewed to qualitatively evaluate peritumoral uptake and to quantify tracer uptake in the tumoral and peritumoral areas. Histology performed on surgical specimens served as the gold standard for all patients. Results: Among 94 included patients, 73% (69/94) had histologically confirmed PLC. Peribronchovascular thickening, lymph node involvement, and increased peritumoral uptake were more often present in patients with PLC (P < 0.009). Metabolic variables, including tumor SUV <sub>max</sub> , SUV <sub>mean</sub> , metabolic tumor volume, and total lesion glycolysis, as well as peritumoral SUV <sub>max</sub> , SUV <sub>mean</sub> , and their respective ratios to background, were significantly higher in the PLC group than in the non-PLC group (P ≤ 0.0039). Sensitivity, specificity, and area under the receiver-operating-characteristic curve for peribronchovascular thickening (69%, 83%, and 0.76, respectively; 95% confidence interval [95%CI], 0.67-0.85) and increased peritumoral uptake (94%, 84%, and 0.89, respectively; 95%CI, 0.81-0.97) were similar (P = 0.054). For detecting PLC, sensitivity, specificity, and area under the receiver-operating-characteristic curve were significantly higher, at 97%, 92%, and 0.98, respectively (95%CI, 0.96-1.00), for peritumoral SUV <sub>max</sub> and 94%, 88%, and 0.96, respectively (95%CI, 0.92-1.00), for peritumoral SUV <sub>mean</sub> (all P ≤ 0.025). Conclusion: Qualitative evaluation of <sup>18</sup> F-FDG PET/CT and HRCT perform similarly for the diagnosis of PLC, with both being outperformed by <sup>18</sup> F-FDG PET/CT quantitative parameters.
Keywords
Radiology Nuclear Medicine and imaging
Pubmed
Web of science
Create date
15/07/2019 17:22
Last modification date
30/01/2020 7:20
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