Value of metabolic parameters in distinguishing primary mediastinal lymphomas from thymic epithelial tumors

Lei Zhu, Xiaofeng Li,, Jian Wang, et al

Abstract


Objective: A high rate of unnecessary thymectomies has been reported. This study aimed to distinguish primary mediastinallymphomas (PMLs) from thymic epithelial tumors (TETs) by evaluating volumetric and metabolic parameters with 18F-FDGPET/CT.

Methods: A total of 136 patients who were pathologically diagnosed with TETs or PMLs were enrolled, and 18F-FDG PET/CT wasperformed before therapy. Volumetric parameters, including the mean SUV (SUVmean), metabolic tumor volume (MTV), totallesion glycolysis (TLG), and SUVmax, were determined and compared between the 2 subtypes. The diagnostic performance of theseparameters was evaluated with receiver operating characteristic (ROC) curve analysis.Results: All parameters significantly differed between patients with PMLs and TETs. Patients with lymphomas were younger andhad higher SUVmean, SUVmax, TLG, and MTV values than patients with TETs. The MTV and TLG values had similar diagnosticperformance. ROC analysis indicated that the areas under the curves of the SUVmean and SUVmax values performed similarly(approximately 0.76) in differentiating patients with PMLs from TETs, and both values were better than the MTV and TLG values.When age was included with the SUVmax in differentiating TETs from PMLs, the AUC was 0.91, and the sensitivity and specificityincreased to 80% and 93%, respectively.

Conclusions: The SUVmax and volumetric parameters of 18F-FDG PET/CT can be used to distinguish patients with PMLs versusTETs, and thus may aid in preventing unnecessary thymectomies or other invasive operations.

Cite this article as: Zhu L, Li X, Wang J, Fu Q, Liu J, Ma W, et al. Value ofmetabolic parameters in distinguishing primary mediastinal lymphomas fromthymic epithelial tumors. Cancer Biol Med. 2020; 17: 468-477. doi: 10.20892/j.issn.2095-3941.2019.0428


Keywords


FDG PET-CT; lymphoma; metabolic tumor burden; quantitative evaluation; thymic epithelial tumors

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