Honghong Liu, Xiaolin Meng, Guanyun Wang, Shulin Yao, Yanmei Wang, Ruimin Wang, Tao Wang
{"title":"FDG PET/CT多参数分析鉴别单发孤立性肺病变伴肺外肿瘤患者第二原发性肺癌与肺转移。","authors":"Honghong Liu, Xiaolin Meng, Guanyun Wang, Shulin Yao, Yanmei Wang, Ruimin Wang, Tao Wang","doi":"10.1007/s12149-025-02034-7","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Using fluorine-18-fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT), a multiparametric analysis will be performed in the differential diagnosis of patients with single solitary pulmonary lesion and extrapulmonary malignant tumor to discriminate between a second primary lung cancer (SPLC) and pulmonary metastasis (PM).</p><h3>Methods</h3><p>This study retrospectively studied 84 patients with preoperative exams utilizing <sup>18</sup>F-FDG PET/CT. Using complementing PET/CT parameters, a composite model was developed. A receiver operating characteristic (ROC) analysis assessed the combined model and each independent parameter's differential diagnostic efficacies. Furthermore, this study investigated the improvement in diagnostic efficacy using other metrics, such as integrated discriminatory improvement (IDI) and net reclassification improvement (NRI).</p><h3>Results</h3><p>The highest discriminative diagnostic value was obtained by the independent parameters energy (1,039,358.1 [95126.2–1,965,032.2] vs. 92,011.0 [45916.3–365,322.9], <i>P</i> = 0.001). In comparison to peak standardized uptake value (SUVpeak), total lesion glycolysis (TLG), energy, lobulation, and spiculation alone, the combined model (addition of these factors) significantly improved the differential diagnostic efficacy of SPLCs and PMs (sensitivity = 76.2%, specificity = 83.8%, area under the curve [AUC] = 0.826) and permitted reclassification using IDI = 0.176 (<i>P</i> < 0.001), 0.169 (<i>P</i> < 0.001), 0.127 (<i>P</i> < 0.001), and categorical NRI = 0.678 (<i>P</i> < 0.001), 0.637 (<i>P</i> < 0.001), and 0.592 (<i>P</i> < 0.001) compared to SUVpeak, TLG and energy separately. DeLong’s test revealed a statistically significant enhancement in ROC when compared to SUVpeak (Z = 2.372, <i>P</i> = 0.018), TLG (Z = 2.095, <i>P</i> = 0.036), and energy (Z = 2.318, <i>P</i> = 0.020).</p><h3>Conclusion</h3><p>Combining multiple parameters using <sup>18</sup>F-FDG PET/CT may further improve distinguishing between SPLCs and PMs in patients with single solitary pulmonary lesion and extrapulmonary malignant tumor.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 6","pages":"567 - 575"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-025-02034-7.pdf","citationCount":"0","resultStr":"{\"title\":\"Differentiating second primary lung cancer from pulmonary metastasis in patients of single solitary pulmonary lesion with extrapulmonary tumor using multiparametric analysis of FDG PET/CT\",\"authors\":\"Honghong Liu, Xiaolin Meng, Guanyun Wang, Shulin Yao, Yanmei Wang, Ruimin Wang, Tao Wang\",\"doi\":\"10.1007/s12149-025-02034-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Using fluorine-18-fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT), a multiparametric analysis will be performed in the differential diagnosis of patients with single solitary pulmonary lesion and extrapulmonary malignant tumor to discriminate between a second primary lung cancer (SPLC) and pulmonary metastasis (PM).</p><h3>Methods</h3><p>This study retrospectively studied 84 patients with preoperative exams utilizing <sup>18</sup>F-FDG PET/CT. Using complementing PET/CT parameters, a composite model was developed. A receiver operating characteristic (ROC) analysis assessed the combined model and each independent parameter's differential diagnostic efficacies. Furthermore, this study investigated the improvement in diagnostic efficacy using other metrics, such as integrated discriminatory improvement (IDI) and net reclassification improvement (NRI).</p><h3>Results</h3><p>The highest discriminative diagnostic value was obtained by the independent parameters energy (1,039,358.1 [95126.2–1,965,032.2] vs. 92,011.0 [45916.3–365,322.9], <i>P</i> = 0.001). In comparison to peak standardized uptake value (SUVpeak), total lesion glycolysis (TLG), energy, lobulation, and spiculation alone, the combined model (addition of these factors) significantly improved the differential diagnostic efficacy of SPLCs and PMs (sensitivity = 76.2%, specificity = 83.8%, area under the curve [AUC] = 0.826) and permitted reclassification using IDI = 0.176 (<i>P</i> < 0.001), 0.169 (<i>P</i> < 0.001), 0.127 (<i>P</i> < 0.001), and categorical NRI = 0.678 (<i>P</i> < 0.001), 0.637 (<i>P</i> < 0.001), and 0.592 (<i>P</i> < 0.001) compared to SUVpeak, TLG and energy separately. DeLong’s test revealed a statistically significant enhancement in ROC when compared to SUVpeak (Z = 2.372, <i>P</i> = 0.018), TLG (Z = 2.095, <i>P</i> = 0.036), and energy (Z = 2.318, <i>P</i> = 0.020).</p><h3>Conclusion</h3><p>Combining multiple parameters using <sup>18</sup>F-FDG PET/CT may further improve distinguishing between SPLCs and PMs in patients with single solitary pulmonary lesion and extrapulmonary malignant tumor.</p></div>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":\"39 6\",\"pages\":\"567 - 575\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-03-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s12149-025-02034-7.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s12149-025-02034-7\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s12149-025-02034-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Differentiating second primary lung cancer from pulmonary metastasis in patients of single solitary pulmonary lesion with extrapulmonary tumor using multiparametric analysis of FDG PET/CT
Objective
Using fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), a multiparametric analysis will be performed in the differential diagnosis of patients with single solitary pulmonary lesion and extrapulmonary malignant tumor to discriminate between a second primary lung cancer (SPLC) and pulmonary metastasis (PM).
Methods
This study retrospectively studied 84 patients with preoperative exams utilizing 18F-FDG PET/CT. Using complementing PET/CT parameters, a composite model was developed. A receiver operating characteristic (ROC) analysis assessed the combined model and each independent parameter's differential diagnostic efficacies. Furthermore, this study investigated the improvement in diagnostic efficacy using other metrics, such as integrated discriminatory improvement (IDI) and net reclassification improvement (NRI).
Results
The highest discriminative diagnostic value was obtained by the independent parameters energy (1,039,358.1 [95126.2–1,965,032.2] vs. 92,011.0 [45916.3–365,322.9], P = 0.001). In comparison to peak standardized uptake value (SUVpeak), total lesion glycolysis (TLG), energy, lobulation, and spiculation alone, the combined model (addition of these factors) significantly improved the differential diagnostic efficacy of SPLCs and PMs (sensitivity = 76.2%, specificity = 83.8%, area under the curve [AUC] = 0.826) and permitted reclassification using IDI = 0.176 (P < 0.001), 0.169 (P < 0.001), 0.127 (P < 0.001), and categorical NRI = 0.678 (P < 0.001), 0.637 (P < 0.001), and 0.592 (P < 0.001) compared to SUVpeak, TLG and energy separately. DeLong’s test revealed a statistically significant enhancement in ROC when compared to SUVpeak (Z = 2.372, P = 0.018), TLG (Z = 2.095, P = 0.036), and energy (Z = 2.318, P = 0.020).
Conclusion
Combining multiple parameters using 18F-FDG PET/CT may further improve distinguishing between SPLCs and PMs in patients with single solitary pulmonary lesion and extrapulmonary malignant tumor.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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