Quantitative analysis of metabolic parameters at 18F‑fluorodeoxyglucose positron emission tomography in predicting malignant potential of anterior mediastinal tumors

Yajima,Toshiki; Mogi,Akira; Shimizu,Kimihiro; Kosaka,Takayuki; Ohtaki,Yoichi; Obayashi,Kai; Nakazawa,Seshiru; Nakajima,Takahito; Tsushima,Yoshito; Shirabe,Ken

doi:10.3892/ol.2020.11276

Quantitative analysis of metabolic parameters at 18F‑fluorodeoxyglucose positron emission tomography in predicting malignant potential of anterior mediastinal tumors

Authors:
- Toshiki Yajima
- Akira Mogi
- Kimihiro Shimizu
- Takayuki Kosaka
- Yoichi Ohtaki
- Kai Obayashi
- Seshiru Nakazawa
- Takahito Nakajima
- Yoshito Tsushima
- Ken Shirabe
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Affiliations: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan, Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan
Published online on: January 9, 2020 https://doi.org/10.3892/ol.2020.11276
Pages: 1865-1871
Copyright: © Yajima et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

To evaluate the utility of 18F‑fluorodeoxyglucose (FDG)‑positron emission tomography (PET) for predicting the malignancy of anterior mediastinal tumors, the present study retrospectively examined a total of 105 consecutive patients who underwent surgical resection of anterior mediastinal tumors at Gunma University Hospital after undergoing a preoperative FDG‑PET scan. Patients were divided into benign and malignant groups in accordance with the following three classification systems: i) Clinical classification, benign or malignant (thymoma and carcinoma); ii) recurrence‑based classification, low‑risk recurrence (benign and low‑risk thymoma) or high‑risk recurrence (high‑risk thymoma and carcinoma); and iii) pathological classification, benign (benign and thymoma) or malignant (carcinoma). The present study analyzed the differences between the benign and malignant groups in terms of FDG‑PET parameters, including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The malignant group exhibited a significantly greater SUVmax than the benign group according to all classification systems. By contrast, there was only a slight difference between groups in volume‑based metabolic parameters (MTV and TLG) using the clinical classification, and no intergroup differences using the recurrence‑based and pathological classifications. The area under the curve in receiver‑operating characteristic curve analysis for predicting malignancy was significantly greater for SUVmax than for volume‑based metabolic parameters using all classification methods. The respective optimal cut‑off value, sensitivity and specificity of SUVmax to predict malignancy were 1.77, 92.0 and 87.0% for the clinical classification, 2.54, 93.6 and 60.3% for the recurrence‑based classification, and 5.15, 78.9 and 90.7% for the pathological classification. SUVmax was the most useful parameter for predicting the malignancy of anterior mediastinal tumors.

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