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

Details

Ressource 1Request a copy Sous embargo jusqu'au 31/01/2021.
State: Public
Version: Author's accepted manuscript
License: Not specified
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 <sup>18</sup>F-FDG PET/CT in Correlation with Clinical Pathologic Outcome.
Journal
Journal of nuclear medicine
Author(s)
Jreige M., Dunet V., Letovanec I., Prior J.O., Meuli R.A., Beigelman-Aubry C., Schaefer N.
ISSN
1535-5667 (Electronic)
ISSN-L
0161-5505
Publication state
Published
Issued date
01/2020
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
Adult, Aged, Aged, 80 and over, Carcinoma/diagnostic imaging, Female, Fluorodeoxyglucose F18, Glycolysis, Humans, Lung/diagnostic imaging, Lung Neoplasms/diagnostic imaging, Lymphangitis/diagnostic imaging, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging/methods, Positron Emission Tomography Computed Tomography, ROC Curve, Radiopharmaceuticals, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, FDG, HRCT, PET/CT, lung cancer, pulmonary lymphangitic carcinomatosis
Pubmed
Web of science
Open Access
Yes
Create date
15/07/2019 16:22
Last modification date
26/08/2020 5:22
Usage data