Diagnostic value of 18F-FDG PET/CT metabolic parameters in solitary lung adenocarcinoma and solitary pulmonary tubercu-losis in elderly patients
Objective To explore the diagnostic value of 18F-FDG PET/CT metabolic parameters in solitary lung ade-nocarcinoma(SLA)and solitary pulmonary tuberculosis(SPT)in elderly patients.Methods The clinical data of 640 elderly patients who underwent 18F-FDG PET/CT examination and were subsequently confirmed by histopathological examinations in Beijing Chest Hospital Affiliated to Capital Medical University from June 2023 to January 2024 were retrospectively analyzed,including 326 cases with SLA(SLA group)and 314 ones with SPT(SPT group).The metabolic parameters of 18F-FDG PET/CT,CT morphological characteristics,coagulation indexes(thromboplastin time,prothrombin time,fibrinogen content,thrombin time,D-dimer,)and tumor markers(carbohydrate antigen 153,neuron-specific enolase)were compared between the two groups.The diagnostic value of 18F-FDG PET/CT in SLA and SPT was analyzed by Kappa consistency analysis.The re-ceiver operating characteristic(ROC)curve was drawn to evaluate the value of each parameter in the differentiation of SLA and SLA in elderly patients.Results All 640 patients completed the examination successfully with clear images and good imaging effect.There was no significant difference in some CT morphological characteristics(morphology,boundary,spicule sign,satellite lesion,cavity,vacuole,air bronchogram,lymph node enlargement)between the two groups(P＞0.05),but there were significant differences in other CT morphological characteristics(lobulation sign,vessel convergence sign,tree-in-bud)between the two groups(P＜0.05).There was no significant difference in metabolic tumor volume(MTV),thromboplastin time or thrombin time between the two groups(P＞0.05).The standardized uptake maximal value(SUVmax),minimal value(SUVmin),mean value(SUVmean)and peak value(SUVpeak)of the SLA group were higher than those of the SPT group,and the prothrombin time,fibrinogen and D-dimer were shorter/lower than those of the SPT group(P＜0.05),the levels of carbohydrate antigen 153 and neuron-specific enolase were higher than those of the SPT group(P＜0.05).Taking SUVmax≥2.5 as the judgement standard,all patients with lung adenocarcinoma had SUVmax values≥2.5,and 89 patients with pulmo-nary tuberculosis had SUVmax values＜2.5.The sensitivity,specificity and accuracy of 18F-FDG PET/CT in the differential diagnosis of SLA and SPT were 100.00%,28.34%and 64.84%,respectively.ROC curves analysis showed that the area un-der the curve(AUC)of SUVmax,SUVmin,SUVmean and SUVpeak in the differential diagnosis of SLA and SPT were 0.723,0.734,0.966 and 0.851,respectively,and AUC of prothrombin time,fibrinogen,D-dimer,carbohydrate antigen 153 and neuron-specific enolase in the differential diagnosis of SLA and SPT were 0.721,0.668,0.793,0.998 and 0.992,re-spectively.Conclusion 18F-FDG PET/CT metabolic parameters have a certain value in the differential diagnosis of SLA and SPT in elderly patients.Taking SUVmax≥2.5 as the judgement standard alone has great limitations,and multiple parameters should be simultaneously used for auxiliary differential diagnosis.
elderlysolitary lung adenocarcinomasolitary pulmonary tuberculosis18F-FDG PET/CT metabolic pa-rameterdiagnostic value
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