Imaging characteristics of nontuberculous mycobacterial pulmonary nodules.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI:10.2478/rjim-2021-0016
Kengo Nishino, Kesato Iguchi, Osamu Ishibashi, Yuika Sasatani, Gen Ohara, Katsunori Kagohashi, Hiroaki Satoh
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Abstract

Abstract Introduction. Nontuberculous mycobacteriosis (NTM) of the lungs can develop nodules. In order to clarify some of the characteristics of lung NTM nodules, we examined volume doubling time (VDT) and maximum standardized uptake value (SUVmax) in positron emission tomography (PET) of pathologically diagnosed NTM nodules. Methods. From November 2012 to August 2018, clinical and radiological information were retrospectively investigated in eight patients who were surgically resected and diagnosed as NTM. These eight patients were followed up until November 2020 and were confirmed to have no appearance of lung cancer or reappearance of lung NTM nodules. The VDT was calculated using the Schwartz formula. Results. The median maximum diameter of the nodule at the time of the first CT scan was 16.0 (range: 9.9–20.0) mm. The median maximum diameter of the nodule on CT performed before the surgical biopsy was 18.8 (range: 10.4–32.8) mm. The median doubling time calculated from these results was 203 (range: 20–568) days. Caseous granulomas and acid-fast bacilli were histologically confirmed in all eight patients. Culture of excised nodules revealed Mycobacterium intracellulare in five patients and Mycobacterium avium in three patients. Six patients received PET, and median SUVmax was: 7.0 (range: 3.3–21.0). Median VDT was around 200 days. Some patients had irregular-shaped nodules. Conclusions. CT/PET-CT characteristics of lung nodules are not reliable in differentiating lung NTM nodules from malignant ones. To avoid unnecessary resection, it may be better to collect various information on imaging findings in the nodule itself and in opacities other than the nodule.
非结核性分枝杆菌肺结节的影像学特征。
介绍。肺非结核性分枝杆菌病(NTM)可形成结节。为了阐明肺NTM结节的一些特征,我们检测了病理诊断的NTM结节的正电子发射断层扫描(PET)的体积倍增时间(VDT)和最大标准化摄取值(SUVmax)。方法。回顾性分析2012年11月至2018年8月8例经手术切除诊断为NTM的患者的临床及影像学资料。这8例患者随访至2020年11月,确认无肺癌表现或肺NTM结节复发。VDT采用Schwartz公式计算。结果。第一次CT扫描时结节的中位最大直径为16.0(范围:9.9-20.0)mm。手术活检前CT上结节的中位最大直径为18.8(范围:10.4-32.8)mm。根据这些结果计算的中位倍增时间为203(范围:20-568)天。8例患者均经组织学证实为干酪样肉芽肿和抗酸杆菌。切除结节的培养显示5例为胞内分枝杆菌,3例为鸟分枝杆菌。6例患者接受PET,中位SUVmax为:7.0(范围:3.3-21.0)。中位VDT约为200天。部分患者有不规则形状的结节。结论。肺结节的CT/PET-CT特征不能可靠地鉴别肺NTM结节与恶性结节。为了避免不必要的切除,最好收集有关结节本身和结节以外的混浊影像的各种信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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