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European Radiology
Published in: European Radiology 12/2015

01-12-2015 | Nuclear Medicine

FDG-PET/CT and FLT-PET/CT for differentiating between lipid-poor benign and malignant adrenal tumours

Authors: Masatoyo Nakajo, Megumi Jinguji, Yoshihiko Fukukura, Yoriko Kajiya, Atushi Tani, Masayuki Nakajo, Yoshiaki Nakabeppu, Hiroshi Arimura, Yoshihiko Nishio, Fumihiko Nakamura, Takashi Yoshiura

Published in: European Radiology | Issue 12/2015

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Abstract

Objective

To compare F-18-fluorodeoxyglucose (FDG) and F-18-fluorothymidine (FLT) PET/CT examinations for differentiating between benign and malignant adrenal tumours.

Methods

Thirty lipid-poor benign and 11 malignant tumours of 40 patients were included. FDG- and FLT-based indices including visual score, maximum standardized uptake value (SUVmax) and FDG adrenal lesion/liver SUVmax (A/L SUVmax) or FLT adrenal lesion/back muscle SUVmax (A/B SUVmax) ratio were compared between benign and malignant tumours using the Mann-Whitney’s U or Wilcoxon signed-rank test, and their diagnostic performances were evaluated by means of the area under the curve (AUC) values derived from the receiver operating characteristic analysis.

Results

All indices were significantly higher in malignant than benign tumours on both images (p < 0.05 each). On FDG-PET/CT, the sensitivity, specificity, and accuracy were 91 %, 63 % and 71 % for visual score, 91 %, 67 % and 73 % for SUVmax, and 100 %, 70 % and 78 % for A/L SUVmax ratio, respectively. On FLT-PET/CT, they were 100 %, 97 % and 98 % for visual score, SUVmax and A/B SUVmax ratio, respectively. All FLT indices were significantly higher than those of FDG in AUC (p < 0.05 each).

Conclusion

FLT-PET/CT may be superior to FDG-PET/CT in differentiating lipid-poor benign from malignant adrenal tumours because of higher specificity and accuracy.

Key Points

• All FDG indices were significantly higher in malignant than in benign tumours.
• All FLT indices were significantly higher in malignant than in benign tumours.
• All FLT indices were significantly higher than those of FDG in AUC.
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Metadata
Title
FDG-PET/CT and FLT-PET/CT for differentiating between lipid-poor benign and malignant adrenal tumours
Authors
Masatoyo Nakajo
Megumi Jinguji
Yoshihiko Fukukura
Yoriko Kajiya
Atushi Tani
Masayuki Nakajo
Yoshiaki Nakabeppu
Hiroshi Arimura
Yoshihiko Nishio
Fumihiko Nakamura
Takashi Yoshiura
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3787-z

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