■骨转移和多发性骨髓瘤(MM)都是恶性疾病,在影像学上可出现溶骨性,并且难以区分。虽然正电子发射断层扫描/计算机断层扫描(PET/CT)已被证明可用于诊断各种骨病变,PET/CT和组织病理学与这些疾病之间的相关性尚不清楚。这项回顾性研究调查了区分MM和骨转移的最佳截止标准摄取值(SUV)。
■新诊断的溶骨性病变(n=344)和疑似恶性肿瘤的患者接受了氟脱氧葡萄糖(FDG)PET/CT和活检/手术。FDG摄取和形态学变化(例如,软组织肿块形成)与病理结果进行比较。
■共评估了8896个溶骨性病变。MM溶骨性病变的SUVmax(1.6±0.7)明显低于骨转移灶的SUVmax(5.5±2.7;p=0.000)。鉴别MM和骨转移的最佳阈值SUVmax为2.65(敏感性86.1%,特异性94.7%;p=0.000)。软组织肿块骨病变的SUVmax高于单纯溶骨病变的SUVmax(p=0.000)。骨转移患者中软组织肿块(7%)的百分比高于MM患者(2%)。骨转移的平均SUVmax为5.5±2.7(0.4-30.4);原发性肿瘤的SUVmax为7.5±4.2(1.0-28.5)。骨转移的SUVmax与原发肿瘤的SUVmax显著相关(r=0.532;p=0.000)。
■FDGPET/CT是鉴别溶骨性病变的有价值的工具。SUVmax鉴别MM与骨转移的最佳临界值为2.65。骨转移的SUVmax与原发肿瘤的SUVmax之间的显着相关性有助于检测原发肿瘤。
UNASSIGNED: Both bone metastases and multiple myeloma (MM) are malignant diseases that can appear osteolytic on imaging and are difficult to differentiate. While positron emission tomography/computed tomography (PET/CT) has been demonstrated useful for the diagnosis of various bone lesions, correlations between PET/CT and histopathology and these diseases are unclear. This retrospective study investigated the optimal cutoff standardized uptake value (SUV) to differentiate MM and bone metastasis.
UNASSIGNED: Patients with newly diagnosed osteolytic lesions (n = 344) and suspected malignancy underwent both fluorodeoxyglucose (FDG) PET/CT and biopsy/surgery. FDG uptake and morphologic changes (e.g., soft tissue mass formation) were compared with pathological results.
UNASSIGNED: A total of 8896 osteolytic lesions were evaluated. The SUVmax of MM osteolytic lesions (1.6 ± 0.7) was significantly lower than that of bone metastases (5.5 ± 2.7; p = 0.000). The best cutoff SUVmax for differentiating MM and bone metastasis was 2.65 (sensitivity 86.1%, specificity 94.7%; p = 0.000). The SUVmax of bone lesions of soft tissue mass was higher than that for pure osteolytic lesions (p = 0.000). A greater percentage of patients with bone metastasis had a soft tissue mass (7%) than did patients with MM (2%). The mean SUVmax of bone metastases was 5.5 ± 2.7 (0.4-30.4); that of primary tumors was 7.5 ± 4.2 (1.0-28.5). The SUVmax of bone metastases significantly correlated with the SUVmax of primary tumors (r = 0.532; p = 0.000).
UNASSIGNED: FDG PET/CT is a valuable tool to differentiate osteolytic lesions. The best cutoff value of SUVmax for differentiating MM from bone metastasis is 2.65. The significant correlation between the SUVmax of bone metastasis and that of primary tumors is helpful for detecting primary tumors.