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Value of 18F-FDG PET/CT in differentiating malignancy of pulmonary artery from pulmonary thromboembolism: a cohort study and literature review

  • Xiao-Ying Xi
  • Wei Gao
  • Juan-Ni Gong
  • Xiao-Juan Guo
  • Jiao-Yan Wu
  • Yuan-Hua Yang
  • Min-Fu YangEmail author
Original Paper

Abstract

To determine the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in differentiating malignancy of pulmonary artery (PA) from pulmonary thromboembolism (PTE) based on a larger number of cases by pooling our cases and those from the literature. Consecutive patients with a PA lesion who had undergone 18F-FDG PET/CT in our hospital were retrospectively reviewed. Moreover, PubMed, Embase, and Medline were searched for literature reporting individual maximum standardised uptake value (SUVmax) of the malignant PA lesion and/or PTE. 18F-FDG activity was compared between PA malignancy and PTE by pooling the data from literature and our patients. Receiver operating characteristic curve analysis was performed to determine the ability of SUVmax to differentiate PA malignancy from PTE. From our database, we identified 11 patients with pulmonary artery sarcoma (PAS), and nine cases of PTE. Fifty patients with a malignant PA lesion (40 cases of PAS and 10 cases of tumor embolism) and 22 subjects with PTE were extracted from the literature. In our cases, the SUVmax of PAS (11.1 ± 4.9, range: 5.5–19.9) was significantly higher than that of PTE (1.9 ± 0.6, range: 1.1–3.2; P < 0.001). There was no significant difference in the SUVmax between the literature data and our cases in malignant lesions or in PTE. Based on the pooled analysis of the literature data and our cases (61 cases of malignant lesions and 31 cases of PTE), the area under the curve for SUVmax to differentiate PA malignancy from PTE was 0.996 (95% CI: 0.989–1.000). At a cutoff value of 3.3, the sensitivity, specificity, and accuracy were 98.4%, 96.8%, and 97.8%, respectively. The 18F-FDG uptake value is an accurate index for determining PA malignancy.

Keywords

Pulmonary artery Sarcoma Pulmonary thromboembolism 18F-FDG SUVmax 

Abbreviations

AUC

Area under the curve

CT

Computed tomography

CTPA

CT pulmonary angiography

FDG

Fluorodeoxyglucose

MRI

Magnetic resonance imaging

MRPA

Magnetic resonance pulmonary angiography

PA

Pulmonary artery

PAS

Pulmonary artery sarcoma

PET

Positron emission tomography

PTE

Pulmonary thromboembolism

ROC

Receiver operating characteristic

ROI

Region of interest

SUVmax

Maximum standardised uptake value

Notes

Compliance with ethical standards

Conflict of interest

All authors declared that they have no conflict of interest.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Xiao-Ying Xi
    • 1
  • Wei Gao
    • 2
  • Juan-Ni Gong
    • 3
  • Xiao-Juan Guo
    • 4
  • Jiao-Yan Wu
    • 1
  • Yuan-Hua Yang
    • 3
  • Min-Fu Yang
    • 1
    Email author
  1. 1.Department of Nuclear MedicineBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
  2. 2.Department of UltrasoundBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
  3. 3.Department of Respiratory and Critical CareBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina
  4. 4.Department of RadiologyBeijing Chaoyang Hospital, Capital Medical UniversityBeijingChina

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