Tags

Type your tag names separated by a space and hit enter

The Role of 18F-FDG PET/CT in the evaluation of Ascites of Undetermined Origin.
J Nucl Med. 2009 Apr; 50(4):506-12.JN

Abstract

The first aim of our study was to compare the role of (18)F-FDG PET/CT with that of CT alone in detecting the primary cause of ascites. A secondary aim was to compare the value of (18)F-FDG PET/CT with that of CT alone in detecting abdominal cavity metastasis. Finally, we analyzed the receiver-operating-characteristic (ROC) curves of maximal standardized uptake values (SUVmax), serum carcinoembryonic antigen, CA19-9, and CA12-5 for differential diagnostic abilities.

METHODS

The (18)F-FDG PET/CT scans of 40 patients with ascites of undetermined origin, including 30 patients with malignant diseases and 10 with benign lesions, were reviewed for the presence of ascites. Among the 40 patients, 34 had received their diagnosis by pathologic examination and 6 by clinical follow-up. We also assessed the (18)F-FDG PET/CT scans of 20 healthy volunteers for comparison. All (18)F-FDG PET/CT images were visually interpreted, and the SUVmax was measured. We compared the mean diameter of true-positive lesions with that of false-negative lesions. The diagnostic abilities of SUVmax, serum carcinoembryonic antigen, CA19-9, and CA12-5 were compared using the ROC curve.

RESULTS

The sensitivity, specificity, and accuracy of PET/CT in detecting the primary cause of ascites were 63.3% (19/30), 70.0% (7/10), and 65.0% (26/40), respectively, and those of CT alone were 36.7% (11/30), 80% (8/10), and 47.5% (19/40), respectively (sensitivity, P < 0.05). The sensitivity of PET/CT was higher than that of CT alone for detecting abdominal cavity metastasis (86.4% vs. 27.3%, P < 0.01). The SUVmax in patients with malignant primary and metastatic lesions was significantly higher than that in healthy volunteers and in patients with benign ascites (P < 0.05). The mean maximal diameter of false-negative lesions was significantly smaller than that of true-positive lesions (P < 0.05). In ROC analysis, the areas under the curve of SUVmax, serum carcinoembryonic antigen, CA19-9, and CA12-5 were 0.803 (P < 0.01), 0.773 (P < 0.05), 0.552 (P > 0.05), and 0.220 (P < 0.01), respectively.

CONCLUSION

(18)F-FDG PET/CT assisted in detecting the original cause of ascites. The differential diagnostic ability of (18)F-FDG PET/CT was superior to that of CT alone, tumor markers, and cytology. More attention should be paid to peritoneal tuberculosis, which can markedly accumulate (18)F-FDG and mimic peritoneal carcinoma.

Authors+Show Affiliations

Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19289438

Citation

Zhang, Miao, et al. "The Role of 18F-FDG PET/CT in the Evaluation of Ascites of Undetermined Origin." Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, vol. 50, no. 4, 2009, pp. 506-12.
Zhang M, Jiang X, Zhang M, et al. The Role of 18F-FDG PET/CT in the evaluation of Ascites of Undetermined Origin. J Nucl Med. 2009;50(4):506-12.
Zhang, M., Jiang, X., Zhang, M., Xu, H., Zhai, G., & Li, B. (2009). The Role of 18F-FDG PET/CT in the evaluation of Ascites of Undetermined Origin. Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, 50(4), 506-12. https://doi.org/10.2967/jnumed.108.056382
Zhang M, et al. The Role of 18F-FDG PET/CT in the Evaluation of Ascites of Undetermined Origin. J Nucl Med. 2009;50(4):506-12. PubMed PMID: 19289438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Role of 18F-FDG PET/CT in the evaluation of Ascites of Undetermined Origin. AU - Zhang,Miao, AU - Jiang,Xufeng, AU - Zhang,Min, AU - Xu,Haoping, AU - Zhai,Ge, AU - Li,Biao, Y1 - 2009/03/16/ PY - 2009/3/18/entrez PY - 2009/3/18/pubmed PY - 2009/6/23/medline SP - 506 EP - 12 JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine JO - J Nucl Med VL - 50 IS - 4 N2 - UNLABELLED: The first aim of our study was to compare the role of (18)F-FDG PET/CT with that of CT alone in detecting the primary cause of ascites. A secondary aim was to compare the value of (18)F-FDG PET/CT with that of CT alone in detecting abdominal cavity metastasis. Finally, we analyzed the receiver-operating-characteristic (ROC) curves of maximal standardized uptake values (SUVmax), serum carcinoembryonic antigen, CA19-9, and CA12-5 for differential diagnostic abilities. METHODS: The (18)F-FDG PET/CT scans of 40 patients with ascites of undetermined origin, including 30 patients with malignant diseases and 10 with benign lesions, were reviewed for the presence of ascites. Among the 40 patients, 34 had received their diagnosis by pathologic examination and 6 by clinical follow-up. We also assessed the (18)F-FDG PET/CT scans of 20 healthy volunteers for comparison. All (18)F-FDG PET/CT images were visually interpreted, and the SUVmax was measured. We compared the mean diameter of true-positive lesions with that of false-negative lesions. The diagnostic abilities of SUVmax, serum carcinoembryonic antigen, CA19-9, and CA12-5 were compared using the ROC curve. RESULTS: The sensitivity, specificity, and accuracy of PET/CT in detecting the primary cause of ascites were 63.3% (19/30), 70.0% (7/10), and 65.0% (26/40), respectively, and those of CT alone were 36.7% (11/30), 80% (8/10), and 47.5% (19/40), respectively (sensitivity, P < 0.05). The sensitivity of PET/CT was higher than that of CT alone for detecting abdominal cavity metastasis (86.4% vs. 27.3%, P < 0.01). The SUVmax in patients with malignant primary and metastatic lesions was significantly higher than that in healthy volunteers and in patients with benign ascites (P < 0.05). The mean maximal diameter of false-negative lesions was significantly smaller than that of true-positive lesions (P < 0.05). In ROC analysis, the areas under the curve of SUVmax, serum carcinoembryonic antigen, CA19-9, and CA12-5 were 0.803 (P < 0.01), 0.773 (P < 0.05), 0.552 (P > 0.05), and 0.220 (P < 0.01), respectively. CONCLUSION: (18)F-FDG PET/CT assisted in detecting the original cause of ascites. The differential diagnostic ability of (18)F-FDG PET/CT was superior to that of CT alone, tumor markers, and cytology. More attention should be paid to peritoneal tuberculosis, which can markedly accumulate (18)F-FDG and mimic peritoneal carcinoma. SN - 0161-5505 UR - https://www.unboundmedicine.com/medline/citation/19289438/The_Role_of_18F_FDG_PET/CT_in_the_evaluation_of_Ascites_of_Undetermined_Origin_ L2 - http://jnm.snmjournals.org/cgi/pmidlookup?view=long&amp;pmid=19289438 DB - PRIME DP - Unbound Medicine ER -