Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Difference in F-18 FDG Uptake According to the Patterns of CT-Based Diagnosed Pulmonary Lymphangitic Carcinomatosis in Patients with Lung Cancer

폐암환자에 있어 CT상으로 진단된 폐림프관성암종증의 형태에 따른 F-18 FDG 섭취의 차이

  • Jun, Sung-Min (Department of Nuclear Medicine, Pusan National University Hospital) ;
  • Kim, Yong-Ki (Department of Nuclear Medicine, Pusan National University Hospital) ;
  • Kim, In-Ju (Department of Nuclear Medicine, Pusan National University Hospital) ;
  • Kim, Seong-Jang (Department of Nuclear Medicine, Pusan National University Hospital) ;
  • Nam, Hyun-Yeol (Department of Nuclear Medicine, Pusan National University Hospital) ;
  • Kim, Bum-Soo (Department of Nuclear Medicine, Pusan National University Hospital)
  • 전성민 (부산대학교 병원 핵의학과) ;
  • 김용기 (부산대학교 병원 핵의학과) ;
  • 김인주 (부산대학교 병원 핵의학과) ;
  • 김성장 (부산대학교 병원 핵의학과) ;
  • 남현열 (부산대학교 병원 핵의학과) ;
  • 김범수 (부산대학교 병원 핵의학과)
  • Published : 2008.08.31
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Abstract

Purpose: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and Methods: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). Results: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: $2.9{\pm}1.4$, group 2: $1.5{\pm}0.6$). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. Conclusion: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.

목적: 이번 연구의 목적은 폐암환자에서 흉부 CT 소견 및 원발 폐암의 조직학적 종류에 따라 폐림프관성암종증(pulmonary lymphangitic carcinomatosis, PLC) 의 F-18 FDG 섭취를 평가하는 것이다. 대상 및 방법: PLC가 있는 폐암환자 33명이 이번 후향적 연구에 포함되었다. 대상에 포함된 모든 환자들은 흉부 CT상으로 PLC를 진단받았다. PLC의 흥부 CT 소견은 중축간질의 침범여부에 따라 분류하였다. 중축간질을 침범한 경우 그룹 1로 분류하였고, 폐변연부간질만 침범한 경우 그룹 2로 분류하였다. F-18 FDG PET/CT를 통하여 PLC의 육안적 및 반정량적 분석을 시행하였다. 우선, PLC 병소에 비정상적인 F-18 FDG 섭취가 있는지 육안으로 분석하였다. PLC 병소에 비정상적인 F-18 FDG 섭취가 있을 경우, PLC 병소에 관심영역을 그려 최대 SUV를 구하였다. 결과: 대상환자군 33명에서 22명의 환자가 육안적 분석상 비정상적인 F-18 FDG 섭취를 보였다. 그룹 1의 환자들에서 그룹 2에 비해 비정상적 F-18 FDG 섭취가 좀 더 높을 빈도로 보이는 경향이 있었으나(그룹 1: 15/19(78.9%), 그룹 2: 7/14(50.0%)), 그룹 1과 그룹 2간에는 육안적 분석상 통계학적으로 유의한 차이는 관찰되지 않았다(p=0.17). 그러나, 그룹 1에서 그룹 2에 비하여 유의하게 높은 최대 SUV를 보였다. (p<0.01, 그룹 1: $2.9{\pm}1.4$, 그룹 2: $1.5{\pm}0.6$). 원발 폐암의 조직학적 분류에 따라서는 PLC 병소의 비정상적인 F-18 FDG 섭취 빈도 및 최대 SUV에 차이는 없었다. 결론: 흉부 CT로 진단된 폐암에 의한 PLC에서 중축간질이 침범된 경우가 폐변연부간질만이 침범된 경우보다 더 높은 최대 SUV를 보인다.

Keywords

References

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