Diagnostic Performance of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT for Chronic Empyema-Associated Malignancy
- Author:
Miju CHEON
1
;
Jang YOO
;
Seung Hyup HYUN
;
Kyung Soo LEE
;
Hojoong KIM
;
Jhingook KIM
;
Jae Il ZO
;
Young Mog SHIM
;
Joon Young CHOI
Author Information
- Publication Type:Original Article
- Keywords: Chronic empyema-associated malignancy; Chronic empyema; ¹⁸F-FDG; PET/CT
- MeSH: Carcinoma, Squamous Cell; Diagnosis; Electrons; Empyema; Fistula; Follow-Up Studies; Humans; Lymphoma, B-Cell; Positron-Emission Tomography and Computed Tomography; Retrospective Studies; ROC Curve; Sensitivity and Specificity
- From:Korean Journal of Radiology 2019;20(8):1293-1299
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The purpose of this study was to evaluate the diagnostic performance of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for chronic empyema-associated malignancy (CEAM). MATERIALS AND METHODS: We retrospectively reviewed the ¹⁸F-FDG PET/CT images of 33 patients with chronic empyema, and analyzed the following findings: 1) shape of the empyema cavity, 2) presence of fistula, 3) maximum standardized uptake value (SUV) of the empyema cavity, 4) uptake pattern of the empyema cavity, 5) presence of a protruding soft tissue mass within the empyema cavity, and 6) involvement of adjacent structures. Final diagnosis was determined based on histopathology or clinical follow-up for at least 6 months. The abovementioned findings were compared between the ¹⁸F-FDG PET/CT images of CEAM and chronic empyema. A receiver operating characteristic (ROC) analysis was also performed. RESULTS: Six lesions were histopathologically proven as malignant; there were three cases of diffuse large B-cell lymphoma, two of squamous cell carcinoma, and one of poorly differentiated carcinoma. Maximum SUV within the empyema cavity (p < 0.001) presence of a protruding soft tissue mass (p = 0.002), and involvement of the adjacent structures (p < 0.001) were significantly different between the CEAM and chronic empyema images. The maximum SUV exhibited the highest diagnostic performance, with the highest specificity (96.3%, 26/27), positive predictive value (85.7%, 6/7), and accuracy (97.0%, 32/33) among all criteria. On ROC analysis, the area under the curve of maximum SUV was 0.994. CONCLUSION: ¹⁸F-FDG PET/CT can be useful for diagnosing CEAM in patients with chronic empyema. The maximum SUV within the empyema cavity is the most accurate ¹⁸F-FDG PET/CT diagnostic criterion for CEAM.
