Prostate incidentaloma on 18F-fluorodeoxyglucose positron emission tomography: Diagnostic value of volumetric positron emission tomography parameters

Özlem Şahin; Buğra Kaya; Zeynep Aydın; Ahmet Eren Şen; Mehmet Sinan İyisoy; Arif Aydın

doi:10.1055/a-1525-7607

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2021; 60(06): 394-402
DOI: 10.1055/a-1525-7607

Original Article

Prostate incidentaloma on 18F-fluorodeoxyglucose positron emission tomography: Diagnostic value of volumetric positron emission tomography parameters

Prostata-Inzidentalom in der 18F-Fluordesoxyglucose-Positronen-Emissions-Tomografie: Diagnostischer Wert der Volumenparameter der Positronen-Emissions-Tomografie

Özlem Şahin

¹Department of Nuclear Medicine, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

,

Buğra Kaya

¹Department of Nuclear Medicine, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

,

Zeynep Aydın

¹Department of Nuclear Medicine, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

,

Ahmet Eren Şen

¹Department of Nuclear Medicine, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

,

Mehmet Sinan İyisoy

²Department of Medical Education and Informatics, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

,

Arif Aydın

³Department of Urology, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey (Ringgold ID: RIN64222)

› Institutsangaben

Abstract

Objective To evaluate whether volumetric PET parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) contributed to maximum standardized uptake value (SUVmax) in predicting prostate carcinoma in the prostate incidentalomas (PI) in 18F-FDG PET/CT.

Materials and methods This retrospective study comprised 107 patients with PI of 4723 male patients who had undergone 18F-FDG PET/CT. SUVmax and volumetric PET parameters of PIs were assessed. MTV and TLG were acquired with each SUV threshold as 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0.

Results The PI incidence was 2.3%, and the malignancy ratio of PI was 15.9%. According to further analysis results, 17 patients were in the malignant group, and 46 patients were in the benign group. Malignant PIs had higher SUVmax (10.6 vs. 6.4 and p<0.01), MTV (all p < 0.01) and TLG (all p < 0.01) than benign incidentalomas. All volumetric PET parameters had higher area under the curve (AUC) than SUVmax. SUVmax AUC was 0.835 [95% confidence interval (CI): 0.728–0.942]. MTV 2.5 and TLG 2.5 had the highest performance for predicting malignant PI.MTV2.5 AUC was 0.871 (95% CI: 0.775–0.968), and TLG2.5 AUC was 0.882 (95% CI: 0.797–0.967). Using TLG 2.5 greater than 29.8 as the cut-off point, the sensitivity and specificity for malignancy prediction were 94.1% and 82.6%, respectively.

Conclusion In this study, in which the effectiveness of volumetric parameters in the diagnosis of PI was evaluated for the first time, it was shown that they could potentially have clinical value along with SUVmax.

Zusammenfassung

Ziel Der Beitrag von PET-Volumenparametern in der 18F-FDG-PET/CT, wie dem metabolischen Tumorvolumen (MTV) und der „total lesion glycolysis“ (TLG), zusätzlich zum maximalen „standardized uptake value“ (SUV_max) zur Prädiktion von Prostatakarzinomen bei Prostata-Inzidentalomen (PI) sollte untersucht werden.

Material und Methoden Diese retrospektive Studie umfasste 107 Patienten mit PI aus 4723 männlichen Patienten, bei denen eine 18F-FDG-PET/CT durchgeführt wurde. SUV_max und PET-Volumenparameter der PIs wurden bewertet. MTV und TLG wurden bei jeder SUV-Schwelle (2,5; 3,0; 3,5; 4,0; 4,5 und 5,0) erfasst.

Ergebnisse Die Inzidenz des PI betrug 2,3% und dessen Malignität 15,9%. Nach den weiteren Analyseergebnissen waren 17 Patienten in der malignen Gruppe und 46 Patienten in der benignen Gruppe. Maligne PIs hatten höhere SUV_max (10,6 vs. 6,4; p<0,01), MTV (alle p<0,01) und TLG (alle p<0,01) als benigne Inzidentalome. Alle PET-Volumenparameter hatten eine höhere AUC als SUV_max. Die SUV_max-AUC betrug 0,835 (95%-Konfidenzintervall (KI) 0,728–0,942). MTV 2,5 und TLG 2,5 erbrachten die höchste Leistung zur Vorhersage eines malignen PI. Die MTV-2,5-AUC betrug 0,871 (95%-KI 0,775–0,968) und die TLG-2,5-AUC 0,882 (95%-KI: 0,797–0,967). Wenn ein TLG 2,5 größer 29,8 als Grenzwert verwendet wurde, dann lag die Sensitivität bei 94,1% und die Spezifität bei 82,6% in Bezug auf die Vorhersage der Malignität.

Schlussfolgerung In dieser Studie, in der die diagnostische Leistungsfähigkeit der Volumenparameter bei PI erstmalig evaluiert wurde, konnte gezeigt werden, dass diese zusammen mit SUV_max einen potenziellen klinischen Wert haben können.

Schlüsselwörter

Prostata-Inzidentalom - volumetrische PET-Parameter - MTV - TLG - SUV

Keywords

prostate incidentaloma - volumetric PET parameters - MTV - TLG - SUV

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Referenzen

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