Is it possible to differentiate pulmonary sarcoidosis in tumor patients and pulmonary lymphangitic carcinomatosis caused by extrapulmonary tumors on 18F-FDG PET/CT images?,Discover Oncology

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Is it possible to differentiate pulmonary sarcoidosis in tumor patients and pulmonary lymphangitic carcinomatosis caused by extrapulmonary tumors on 18F-FDG PET/CT images?
Discover Oncology Pub Date : 2023-12-11 , DOI: 10.1007/s12672-023-00848-3
Yu Ji ₁ , Yaru Wang ₁ , Jie Jiang ₂ , Min Chen ₃ , Juan Xiao ₄ , Zhengjun Dai ₅ , Jingsong Zheng ₆

Affiliation

Purpose

Pulmonary sarcoidosis (PS) and pulmonary lymphangitic carcinomatosis (PLC) can be complications in tumor patients, and both involve the pulmonary interstitium and have similar imaging findings. Our objective was to distinguish PS and PLC on 18F-FDG PET/CT images.

Material and methods

The authors reviewed 18F-FDG PET/CT data of PS and PLC, diagnosed based on histopathology and imaging, in patients with tumors from July 2015 to January 2023. Three independent readers performed a blinded comparative analysis of 18F-FDG PET/CT signs in all patients. A multivariate logistic regression model was used to establish a differential diagnosis model.

Results

A total of 114 patients were included in the study: 56 patients with PS (mean age, 56 ± 11 [SD] years; 10 men) and 58 patients with PLC caused by extrapulmonary tumors (mean age, 51 ± 11 [SD] years; 21 men). For PS, breast cancer and cervical cancer were the most common primary tumors. For PLC, breast cancer and gastric cancer were the most common extrapulmonary tumors. The model constructed using multivariate logistic regression consisted of five factors: area of lymph node involvement, bronchovascular bundle diffuse thickening, interlobular septal thickening, pleural effusion, and subpleural hypermetabolic activity. The area under the model characteristic curve was 0.973 (95% CI 0.925–0.994), with a sensitivity, specificity, and positive and negative likelihood ratios of 87.50%, 98.28%, 50.75 and 0.13 respectively.

Conclusion

There are detailed differences in 18F-FDG PET/CT manifestations of PS in tumor patients and PLC caused by extrapulmonary tumors, and the constructed diagnostic model has high clinical application value in differentiating the two.

中文翻译：

18F-FDG PET/CT图像能否区分肿瘤患者的肺结节病和肺外肿瘤引起的肺淋巴管癌病？

目的

肺结节病（PS）和肺癌性淋巴管病（PLC）可能是肿瘤患者的并发症，两者均累及肺间质，且具有相似的影像学表现。我们的目标是在 18F-FDG PET/CT 图像上区分 PS 和 PLC。

材料与方法

作者回顾了 2015 年 7 月至 2023 年 1 月肿瘤患者中根据组织病理学和影像学诊断的 PS 和 PLC 的 18F-FDG PET/CT 数据。三位独立读者对 18F-FDG PET/CT 征象进行了盲法比较分析所有患者。采用多元Logistic回归模型建立鉴别诊断模型。

结果

该研究总共纳入了 114 名患者：56 名 PS 患者（平均年龄，56 ± 11 [SD] 岁；10 名男性）和 58 名肺外肿瘤引起的 PLC 患者（平均年龄，51 ± 11 [SD] 岁） ; 21 人）。对于 PS，乳腺癌和宫颈癌是最常见的原发肿瘤。对于PLC，乳腺癌和胃癌是最常见的肺外肿瘤。使用多元逻辑回归构建的模型由五个因素组成：淋巴结受累面积、支气管血管束弥漫性增厚、小叶间隔增厚、胸腔积液和胸膜下代谢亢进。模型特征曲线下面积为0.973（95% CI 0.925-0.994），敏感性、特异性、阳性和阴性似然比分别为87.50%、98.28%、50.75和0.13。