Published in:
01-08-2011 | Original Article
Differentiation of malignant from benign heart and pericardial lesions using positron emission tomography and computed tomography
Published in: Journal of Nuclear Cardiology | Issue 4/2011
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Objective
To assess the feasibility of 18F-FDG PET-CT for the differentiation of malignancy from benign lesions of the heart and the pericardium.
Methods
A total of 23 cases (malignancy:benign = 13:10) with cardiac and pericardial lesions, confirmed by pathology or on clinical grounds, were analyzed in this study. All lesions were evaluated semi-quantitatively using maximum standard uptake values (SUVmax) and SUVmax lesion/blood, and the density of the heart and pericardium lesions and the relation with surrounding tissues were evaluated. The differences of SUVmax and SUVmax lesion/blood between benign and malignant lesions were analyzed by the Mann-Whitney test. Subsequently, the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for CT and PET-CT, respectively.
Results
The maximum SUV showed significant difference between malignancy (avg ± SD 6.5) and benign (avg ± SD 1.5) (Z = −3.601, P < .01), the SUVmax lesion/blood of malignancy and benign were avg ± SD 3.4 and avg ± SD 0.9, respectively, also with a significant difference (Z = −3.600, P < .01). In this pilot study, the optimal cutoff value to separate benign vs malignant lesions of SUVmax was 3.5-4.0 and the cutoff for SUVmax lesion/blood was 1.3-2.0. The sensitivity, specificity, accuracy, PPV, and NPV of CT and PET-CT were 76.9%(10/13), 100.0%(10/10), 87.0%(20/23), 100.0%(10/10), 76.9%(10/13) and 100.0%(13/13), 90.0%(9/10), 95.7%(22/23), 92.9%(13/14), 100.0%(9/9), respectively.
Conclusion
18F-FDG PET-CT appears promising for correctly differentiating benign vs malignant cardiac and pericardial lesions.