Masatoyo Nakajo1, Megumi Jinguji2, Masayuki Nakajo3, Tetsuya Shinaji4, Yoshiaki Nakabeppu2, Yoshihiko Fukukura2, Takashi Yoshiura2. 1. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. toyo.nakajo@dolphin.ocn.ne.jp. 2. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. 3. Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan. 4. Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Abstract
PURPOSE: To retrospectively investigate the SUV-related and texture parameters individually and in combination for differentiating between F-18-fluorodeoxyglucose (FDG)-avid benign and metastatic adrenal tumors with PET/CT. METHODS: Thirteen benign adrenal tumors (BATs) and 22 metastatic adrenal tumors (MATs) with a metabolic tumor volume (MTV) > 10.0 cm3 and SUV ≥ 2.5 were included. SUVmax, MTV, total lesion glycolysis, and four textural parameters [entropy, homogeneity, intensity variability (IV), and size-zone variability] were obtained. These parameters were compared between BATs and MATs using Mann-Whitney U test, and the diagnostic performance was evaluated by the area under the curve (AUC) values derived from the receiver operating characteristic analysis. The diagnostic value of combining SUV and texture parameters was examined using a scoring system. RESULTS: MATs showed significantly higher SUVmax (p = 0.004), entropy (p = 0.013), IV (p = 0.006), and lower homogeneity (p = 0.019) than BATs. The accuracies for diagnosing MATs were 82.9, 82.9, 85.7, and 71.4% for SUVmax, entropy, IV, and homogeneity, respectively. No significant differences in AUC were found among these parameters (p > 0.05 each). When each parameter was scored as 0 (negative for malignancy) and 1 (positive for malignancy) according to each threshold criterion and the four parameter summed scores 0, 1, and 2 were defined as benignity and 3 and 4 as malignancy, the sensitivity and specificity and accuracy to predict MATs were 100% (22/22), 84.6% (11/13), and 94.3% (33/35), respectively, with 0.97 of the AUC. CONCLUSION: The combined use of SUVmax and texture parameters has a potential to significantly increase the diagnostic performance to differentiate between large FDG-avid BATs and MATs.
PURPOSE: To retrospectively investigate the SUV-related and texture parameters individually and in combination for differentiating between F-18-fluorodeoxyglucose (FDG)-avid benign and metastatic adrenal tumors with PET/CT. METHODS: Thirteen benign adrenal tumors (BATs) and 22 metastatic adrenal tumors (MATs) with a metabolic tumor volume (MTV) > 10.0 cm3 and SUV ≥ 2.5 were included. SUVmax, MTV, total lesion glycolysis, and four textural parameters [entropy, homogeneity, intensity variability (IV), and size-zone variability] were obtained. These parameters were compared between BATs and MATs using Mann-Whitney U test, and the diagnostic performance was evaluated by the area under the curve (AUC) values derived from the receiver operating characteristic analysis. The diagnostic value of combining SUV and texture parameters was examined using a scoring system. RESULTS: MATs showed significantly higher SUVmax (p = 0.004), entropy (p = 0.013), IV (p = 0.006), and lower homogeneity (p = 0.019) than BATs. The accuracies for diagnosing MATs were 82.9, 82.9, 85.7, and 71.4% for SUVmax, entropy, IV, and homogeneity, respectively. No significant differences in AUC were found among these parameters (p > 0.05 each). When each parameter was scored as 0 (negative for malignancy) and 1 (positive for malignancy) according to each threshold criterion and the four parameter summed scores 0, 1, and 2 were defined as benignity and 3 and 4 as malignancy, the sensitivity and specificity and accuracy to predict MATs were 100% (22/22), 84.6% (11/13), and 94.3% (33/35), respectively, with 0.97 of the AUC. CONCLUSION: The combined use of SUVmax and texture parameters has a potential to significantly increase the diagnostic performance to differentiate between large FDG-avid BATs and MATs.
Authors: Mark Sherlock; Andrew Scarsbrook; Afroze Abbas; Sheila Fraser; Padiporn Limumpornpetch; Rosemary Dineen; Paul M Stewart Journal: Endocr Rev Date: 2020-12-01 Impact factor: 19.871
Authors: George Amadeus Prenosil; Thilo Weitzel; Markus Fürstner; Michael Hentschel; Thomas Krause; Paul Cumming; Axel Rominger; Bernd Klaeser Journal: PLoS One Date: 2020-03-16 Impact factor: 3.240