The role of F-18-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours

作者：Dijkman Bernadette G; Schuurbiers Olga C J^*; Vriens Dennis; Looijen Salamon Monika; Bussink Johan; Timmer Bonte Johanna N H; Snoeren Miranda M; Oyen Wim J G; van der Heijden Henricus F M; de Geus Oei Lioe Fee

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2010, 37(11): 2037-2047.

DOI：10.1007/s00259-010-1505-2

• FDG PET
• Second primary tumour
• Metastatic disease
• Lung cancer
• Standardized uptake value
• CT

In lung cancer patients with multiple lesions, the differentiation between metastases and second primary tumours has significant therapeutic and prognostic implications. The aim of this retrospective study was to investigate the potential of F-18-FDG PET to discriminate metastatic disease from second primary lung tumours.
Of 1,396 patients evaluated by the thoracic oncology group between January 2004 and April 2009 at the Radboud University Nijmegen Medical Centre, patients with a synchronous second primary lung cancer were selected. Patients with metastatic disease involving the lungs served as the control group. Maximum standardized uptake values (SUVs) measured with F-18-FDG PET were determined for two tumours in each patient. The relative difference between the SUVs of these tumours (a dagger SUV) was determined and compared between the second primary group and metastatic disease group. Receiver-operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the a dagger SUV for an optimal cut-off value.
A total of 37 patients (21 metastatic disease, 16 second primary cancer) were included for analysis. The a dagger SUV was significantly higher in patients with second primary cancer than in those with metastatic disease (58 vs 28%, respectively, p < 0.001). The area under the ROC curve was 0.81 and the odds ratio for the optimal cut-off was 18.4.
SUVs from F-18-FDG PET images can be helpful in differentiating metastatic disease from second primary tumours in patients with synchronous pulmonary lesions. Further studies are warranted to confirm the consistency of these results.

• 出版日期2010-11