Martina Romanisio, Tommaso Daffara, Rosa Pitino, Alice Ferrero, Francesca Pizzolitto, Marco Zavattaro, Federica Biello, Alessandra Gennari, Alessandro Volpe, Gian Mauro Sacchetti, Paolo Marzullo, Gianluca Aimaretti, Flavia Prodam, Marina Caputo
{"title":"肾上腺病变中的[18F]FDG-PET/CT：不同临床环境中的诊断性能","authors":"Martina Romanisio, Tommaso Daffara, Rosa Pitino, Alice Ferrero, Francesca Pizzolitto, Marco Zavattaro, Federica Biello, Alessandra Gennari, Alessandro Volpe, Gian Mauro Sacchetti, Paolo Marzullo, Gianluca Aimaretti, Flavia Prodam, Marina Caputo","doi":"10.1007/s12020-024-04042-5","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Data regarding [18<sup>F</sup>]FDG-PET/CT for the characterization of adrenal lesions are limited. Most of the studies proposed the tumor-to-liver maximum standardized uptake values (SUVratio) > 1.5 as the best cut off to predict malignancy. The aim of the study was to calculate the optimum cut off in a heterogeneous population with adrenal lesions and evaluate the diagnostic performance SUVratio >1.5.</p><h3 data-test=\"abstract-sub-heading\">Patients and methods</h3><p>Retrospective analysis of adrenal lesions undergoing [18<sup>F</sup>]FDG-PET/CT (2013–2022) for different reasons (atypical adrenal incidentalomas, extra adrenal tumor staging). The diagnosis of benignity was assessed by: (i) histology; (ii) stability or minimal diameter increase (<20%/<5 mm) on 12-months follow-up for non-operated patients. The optimal SUVratio and performance of SUVratio >1.5 were calculated by ROC curves.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Forty-two consecutive lesions (diameter 36.1 ± 20.3 mm, 6 bilateral) underwent [18<sup>F</sup>]FDG-PET/CT (19F, age 61.2 ± 11.7 years). Twenty-nine lesions were benign, 11 malignant [8 metastases (2 bilateral) and 1 adrenocortical carcinoma (ACC)] and 2 pheochromocytomas. The SUVratio cut-off in our population was 1.55 (Sn 100%, Sp 73.7%, AUC 0.868), with similar values excluding pheochromocytomas and metastases (SUVratio cut-off 1.49, Sn 100%, Sp 96.3%, AUC 0.988). The SUVratio cut-off of 1.5 showed 100% Sn, 87% Sp, 73% PPV, and 100% NPV.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>[18<sup>F</sup>]FDG-PET/CT could help in decision making process avoiding unnecessary surgery. The SUVratio cut-off of 1.5 has a good performance in a heterogenous population.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"63 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[18F]FDG-PET/CT in adrenal lesions: diagnostic performance in different clinical settings\",\"authors\":\"Martina Romanisio, Tommaso Daffara, Rosa Pitino, Alice Ferrero, Francesca Pizzolitto, Marco Zavattaro, Federica Biello, Alessandra Gennari, Alessandro Volpe, Gian Mauro Sacchetti, Paolo Marzullo, Gianluca Aimaretti, Flavia Prodam, Marina Caputo\",\"doi\":\"10.1007/s12020-024-04042-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>Data regarding [18<sup>F</sup>]FDG-PET/CT for the characterization of adrenal lesions are limited. Most of the studies proposed the tumor-to-liver maximum standardized uptake values (SUVratio) > 1.5 as the best cut off to predict malignancy. The aim of the study was to calculate the optimum cut off in a heterogeneous population with adrenal lesions and evaluate the diagnostic performance SUVratio >1.5.</p><h3 data-test=\\\"abstract-sub-heading\\\">Patients and methods</h3><p>Retrospective analysis of adrenal lesions undergoing [18<sup>F</sup>]FDG-PET/CT (2013–2022) for different reasons (atypical adrenal incidentalomas, extra adrenal tumor staging). The diagnosis of benignity was assessed by: (i) histology; (ii) stability or minimal diameter increase (<20%/<5 mm) on 12-months follow-up for non-operated patients. 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[18F]FDG-PET/CT in adrenal lesions: diagnostic performance in different clinical settings
Purpose
Data regarding [18F]FDG-PET/CT for the characterization of adrenal lesions are limited. Most of the studies proposed the tumor-to-liver maximum standardized uptake values (SUVratio) > 1.5 as the best cut off to predict malignancy. The aim of the study was to calculate the optimum cut off in a heterogeneous population with adrenal lesions and evaluate the diagnostic performance SUVratio >1.5.
Patients and methods
Retrospective analysis of adrenal lesions undergoing [18F]FDG-PET/CT (2013–2022) for different reasons (atypical adrenal incidentalomas, extra adrenal tumor staging). The diagnosis of benignity was assessed by: (i) histology; (ii) stability or minimal diameter increase (<20%/<5 mm) on 12-months follow-up for non-operated patients. The optimal SUVratio and performance of SUVratio >1.5 were calculated by ROC curves.
Results
Forty-two consecutive lesions (diameter 36.1 ± 20.3 mm, 6 bilateral) underwent [18F]FDG-PET/CT (19F, age 61.2 ± 11.7 years). Twenty-nine lesions were benign, 11 malignant [8 metastases (2 bilateral) and 1 adrenocortical carcinoma (ACC)] and 2 pheochromocytomas. The SUVratio cut-off in our population was 1.55 (Sn 100%, Sp 73.7%, AUC 0.868), with similar values excluding pheochromocytomas and metastases (SUVratio cut-off 1.49, Sn 100%, Sp 96.3%, AUC 0.988). The SUVratio cut-off of 1.5 showed 100% Sn, 87% Sp, 73% PPV, and 100% NPV.
Conclusion
[18F]FDG-PET/CT could help in decision making process avoiding unnecessary surgery. The SUVratio cut-off of 1.5 has a good performance in a heterogenous population.
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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