serval:BIB_2665FFBF2930
Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and <sup>18</sup>F-FDG PET/CT in Correlation with Clinical Pathologic Outcome.
10.2967/jnumed.119.229575
000505203800008
31227574
Jreige
M.
author
Dunet
V.
author
Letovanec
I.
author
Prior
J.O.
author
Meuli
R.A.
author
Beigelman-Aubry
C.
author
Schaefer
N.
author
article
2020-01
Journal of nuclear medicine
1535-5667
0161-5505
journal
61
1
26-32
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.
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
eng
60_published
true
peer-reviewed
Publication types: Journal Article
Publication Status: ppublish
University of Lausanne
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