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68Ga-Prostate-Specific Membrane Antigen-Avid Malignant Pleural Effusion in a Patient With Metastatic Adenoid Cystic Carcinoma and Concordance With 18F-FDG PET/CT.

ABSTRACT:

Abstract

Adenoid cystic carcinoma (ACC) is a rare cancer that arises from salivary glands and other secretory glands. Pulmonary metastases are frequently observed in ACC patients with metastatic disease. Previous research showed that ACC often shows high PSMA uptake on 68Ga-PSMA-11 PET/CT. Here, we present PET images from an ACC patient with pulmonal, pleural metastases, and malignant pleural effusion, with comparable tracer uptake on 68Ga-PSMA-11 PET and 18F-FDG PET.

SUBMITTER: Uijen MJM

PROVIDER: S-EPMC8746899 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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68Ga-Prostate-Specific Membrane Antigen-Avid Malignant Pleural Effusion in a Patient With Metastatic Adenoid Cystic Carcinoma and Concordance With 18F-FDG PET/CT.

Uijen Maike José Maria MJM Weijers Jetty Anne Mina JAM Driessen Chantal Maria Leonarda CML van Herpen Carla Marie Louise CML Nagarajah James J

Clinical nuclear medicine 20220201 2

<h4>Abstract</h4>Adenoid cystic carcinoma (ACC) is a rare cancer that arises from salivary glands and other secretory glands. Pulmonary metastases are frequently observed in ACC patients with metastatic disease. Previous research showed that ACC often shows high PSMA uptake on 68Ga-PSMA-11 PET/CT. Here, we present PET images from an ACC patient with pulmonal, pleural metastases, and malignant pleural effusion, with comparable tracer uptake on 68Ga-PSMA-11 PET and 18F-FDG PET. ...[more]

PMID: 35006109

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Project description:ObjectiveThe aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion.MethodsA total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging.ResultsOne hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with 18F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively).Conclusion18F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than 18F-FDG PET imaging and CT imaging alone. For image interpretation of 18F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively.

Project description:Purpose Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and gallium-68 (68Ga)-somatostatin analog (SSA) PET/CT imaging have been increasingly used in ectopic adrenocorticotropic hormone syndrome (EAS); however, the diagnostic efficacies of these two methods in patients with EAS remain unclear. Our study aimed to compare the diagnostic efficacies of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT in EAS. Methods The clinical and imaging data of 68 patients with EAS who underwent 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT examinations from December 2016 to April 2021 were analyzed retrospectively, and the diagnostic efficacies of these methods were compared. Results In 37 cases, imaging was performed to locate the primary tumor lesion (localization group), and in 31 to evaluate tumor load or metastasis (staging group). Primary tumors were detected in 48.65% (18/37) of the localization group patients. According to scan-based analysis, the tumor lesion detection rates and false positive rates of 18F-FDG PET/CT imaging and 68Ga-DOTANOC PET/CT imaging were 18.92% vs. 45.95% (p < 0.05) and 21.62% vs. 2.70% (p < 0.05) respectively. For lesion-based analysis, the tumor lesion detection rates and false positive rates were 24.13% vs. 58.62% (p >0.05) and 31.04% vs. 3.45% (p < 0.05). In 90.32% (28/31) of the staging group patients, 286 of 292 lesions were confirmed as tumor lesions. Based on scan analysis, the detection rates and false positive rates of 18F-FDG PET/CT imaging and 68Ga-DOTANOC PET/CT imaging were 83.87% vs. 67.74% (p > 0.05) and 12.90% vs. 9.68% (p > 0.05) respectively. Based on lesion analysis, the detection rate and false positive rates were 93.84% vs. 54.80% (p < 0.05) and 1.37% vs. 1.03%(p > 0.05). Conclusion 68Ga-DOTANOC PET/CT imaging may be more suitable than 18F-FDG PET/CT for identifying the primary tumor in patients with EAS, while 18F-FDG PET/CT may be more advantageous than 68Ga-DOTANOC PET/CT for patients with suspected metastasis.

Dataset Information

68Ga-Prostate-Specific Membrane Antigen-Avid Malignant Pleural Effusion in a Patient With Metastatic Adenoid Cystic Carcinoma and Concordance With 18F-FDG PET/CT.

Abstract

Publications

68Ga-Prostate-Specific Membrane Antigen-Avid Malignant Pleural Effusion in a Patient With Metastatic Adenoid Cystic Carcinoma and Concordance With 18F-FDG PET/CT.

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