Takayoshi Shinya1,2,3, Yoichi Otomi4, Toshihiko Nishisho5, Bettina Beuthien-Baumann6, Michiko Kubo4, Hideki Otsuka7, Yoshimi Bando8, Hiroaki Yanagawa9, Koichi Sairyo5, Masafumi Harada4. 1. Department of Radiology, Tokushima University Hospital, 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. midnight-2005@nifty.com. 2. Division of Radiology, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. midnight-2005@nifty.com. 3. Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan. midnight-2005@nifty.com. 4. Department of Radiology, Tokushima University Hospital, 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. 5. Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. 6. Division of Radiology, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. 7. Department of Medical Imaging/Nuclear Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. 8. Division of Pathology, Tokushima University Hospital, 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. 9. Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, 2 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
Abstract
BACKGROUND: This study prospectively assessed the diagnostic capacity of dynamic carbon-11 methionine (C-11 MET) positron-emission tomography (PET)/computed tomography for the diagnosis of pathologies in patients with primary unknown musculoskeletal lesions (MSLs). In total, 13 patients with MSLs underwent dynamic scans (5-10 [phase 1], 10-15 [phase 2], 15-20 [phase 3], 20-25 [phase 4], 25-30 [phase 5], and 30-35 [phase 6] min post-injection of C-11 MET). We statistically compared the maximum standardised uptake values (SUVmax) and corresponding retention index for dynamic scans (RI-SUV) for five benign MSLs (BMSLs), five primary malignant musculoskeletal tumours (PMMSTs), four metastatic musculoskeletal tumours (MMSTs), and three malignant lymphoma (ML) cases and explored their diagnostic capacities using receiver operating characteristic (ROC) curve analyses. RESULTS: SUVmax gradually decreased or remained similar with minimal fluctuations in all BMSL cases and four of five PMMST cases. In contrast, SUVmax increased over time in one case of PMMST and in all cases of MMST and ML. Significant differences were observed in SUVmax for all time phases and RI-SUV between BMSLs and MMSLs, in SUVmax for all time phases between PMMSTs and BMSLs, in SUVmax for all time phases and RI-SUV between non-PMMST-malignant tumours and BMSL, and in RI-SUV between non-PMMST-malignant tumours and PMMST. In ROC analyses, the areas under the curve yielded the highest values at 1.00 for differentiating most intergroup comparisons. CONCLUSIONS: Dynamic C-11 MET PET scans have the potential to be good predictors of discriminating MSLs in patients with primary unknown MSLs in clinical practice.
BACKGROUND: This study prospectively assessed the diagnostic capacity of dynamic carbon-11 methionine (C-11 MET) positron-emission tomography (PET)/computed tomography for the diagnosis of pathologies in patients with primary unknown musculoskeletal lesions (MSLs). In total, 13 patients with MSLs underwent dynamic scans (5-10 [phase 1], 10-15 [phase 2], 15-20 [phase 3], 20-25 [phase 4], 25-30 [phase 5], and 30-35 [phase 6] min post-injection of C-11 MET). We statistically compared the maximum standardised uptake values (SUVmax) and corresponding retention index for dynamic scans (RI-SUV) for five benign MSLs (BMSLs), five primary malignant musculoskeletal tumours (PMMSTs), four metastatic musculoskeletal tumours (MMSTs), and three malignant lymphoma (ML) cases and explored their diagnostic capacities using receiver operating characteristic (ROC) curve analyses. RESULTS: SUVmax gradually decreased or remained similar with minimal fluctuations in all BMSL cases and four of five PMMST cases. In contrast, SUVmax increased over time in one case of PMMST and in all cases of MMST and ML. Significant differences were observed in SUVmax for all time phases and RI-SUV between BMSLs and MMSLs, in SUVmax for all time phases between PMMSTs and BMSLs, in SUVmax for all time phases and RI-SUV between non-PMMST-malignant tumours and BMSL, and in RI-SUV between non-PMMST-malignant tumours and PMMST. In ROC analyses, the areas under the curve yielded the highest values at 1.00 for differentiating most intergroup comparisons. CONCLUSIONS: Dynamic C-11 MET PET scans have the potential to be good predictors of discriminating MSLs in patients with primary unknown MSLs in clinical practice.
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