Characteristics of endometriosis in 18F-FDG PET/CT imaging
10.3760/cma.j.cn321828-20220701-00205
- VernacularTitle:子宫内膜异位症的 18F-FDG PET/CT表现
- Author:
Mingzhen XU
1
;
Shuai LIU
;
Shaoli SONG
Author Information
1. 复旦大学附属肿瘤医院核医学科、复旦大学上海医学院肿瘤学系、复旦大学生物医学影像研究中心、上海分子影像探针工程技术研究中心、核物理与离子束应用教育部重点实验室，上海 200032
- Keywords:
Endometriosis;
CA-125 antigen;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorodeoxyglucose F18
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2023;43(10):599-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the 18F-FDG PET/CT imaging features in endometriosis (EMS), in order to provide valuable information for accurate clinical diagnosis. Methods:The clinical and imaging data of 21 patients (age range 23-72 (44.0±11.4) years) who underwent 18F-FDG PET/CT imaging in Fudan University Shanghai Cancer Center between December 2016 and May 2021, and were pathologically confirmed to be EMS, were retrospectively collected. The symptoms and signs, carbohydrate antigen (CA)125 levels, and the characteristics of the lesions on PET/CT images were analyzed. According to the intraoperative lesion invasion score, patients were divided into group A with lesion confined to the adnexal region (the score ≤4), and group B with multiple sites invaded (the score >4). The differences in age, CA125, SUV max, SUV mean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were analyzed by independent-sample t test or Mann-Whitney U test. Results:About 42.9%(9/21) had a history of dysmenorrhea. CA125 was elevated in 95.2%(20/21) of the patients. CA125 levels of the group A and group B were 88.4(42.0, 351.5) and 619.8(72.3, 1 420.0) kU/L, respectively, which meant the higher the CA125 and the wider the lesion involvement ( z=-2.32, P=0.041). The older the patients, the more likely the lesions were confined to the adnexal region ( t=-2.10, P=0.049). The SUV max of the two groups were 3.67±1.78 and 3.93±1.88, respectively ( t=0.33, P=0.746). The other metabolic parameters (SUV mean, MTV and TLG) of the 2 groups were not significantly different either ( t=0.79, both z=-1.16, P values: 0.446, 0.245, 0.245). About 23.8%(5/21) of patients were with SUV max greater than 5, and 4 of them had inflammation. Conclusions:EMS patients are often accompanied by abdominal pain and increased CA125. The older the age, the more prone to focal involvement of appendages. The higher the CA125 level, the wider the lesion involvement. The 18F-FDG metabolism level has nothing to do with the scope of the lesion, but when the SUV max of the lesion >5, it is often accompanied by acute inflammation, which is easy to be misdiagnosed.
