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The Clinical Usefulness of 18F-FDG PET/CT in Patients with Systemic Autoimmune Disease

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Abstract

Purpose

Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of 18F-FDG PET/CT in patients with systemic autoimmune disease.

Methods

Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs.

Results

FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC = 1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P = 0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P = 0.040).

Conclusions

PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false-positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju, 501-757, South Korea

    Jong-Ryool Oh, Ho-Chun Song, Sae-Ryung Kang, Su-Woong Yoo, Jahae Kim, Ari Chong, Jung-Joon Min & Hee-Seung Bom

  2. Department of Rheumatology, Chonnam National University Hospital, Gwangju, South Korea

    Shin-Seok Lee & Yong-Wook Park

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  1. Jong-Ryool Oh
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  2. Ho-Chun Song
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Correspondence to Ho-Chun Song.

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Oh, JR., Song, HC., Kang, SR. et al. The Clinical Usefulness of 18F-FDG PET/CT in Patients with Systemic Autoimmune Disease. Nucl Med Mol Imaging 45, 177–184 (2011). https://doi.org/10.1007/s13139-011-0094-8

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  • DOI: https://doi.org/10.1007/s13139-011-0094-8

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