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Japanese Journal of Radiology

Erschienen in:

13.10.2022 | Original Article

PET morphology helps distinguish solitary and solid pulmonary tuberculosis from non-small cell lung cancer

verfasst von: Qiang Li, Yuan Li, Hui Yuan, Fujun Yang, Yan Huang, Xiao Song, Lei Jiang

Erschienen in: Japanese Journal of Radiology | Ausgabe 3/2023

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Abstract

Objective

Solitary and solid pulmonary tuberculosis (PTB) and non-small cell lung cancer (NSCLC) can present overlapping imaging features, causing diagnostic dilemmas. Hence, this study aimed to identify positron emission tomography (PET) morphological features derived from fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) images for a better differential diagnosis.

Methods

Clinical records and ¹⁸F-FDG PET/CT images of 175 patients confirmed with PTB and 311 patients with NSCLC were retrospectively reviewed. Parameters including patient demographics, PET-derived morphological features and metabolic parameters, and CT-derived morphological features were investigated. Logistic regression analysis was performed to assess the independent predictive factors associated with PTB.

Results

PTB presented with more heterogeneous glucometabolism than NSCLC in PET imaging (50% vs 17%, P < 0.05), especially in lesions with a maximum diameter < 30 mm (39% vs. 5%, P < 0.05). NSCLC usually showed centric hypometabolism, whereas PTB more frequently presented with an eccentric metabolic pattern, mainly including piebald, half-side, lesser curvature, and greater curvature shapes. Multivariate logistic regression identified that glucometabolic heterogeneity, eccentric hypometabolism, smaller lesion size, calcification, satellite lesions, and higher CT value of the hypometabolic area were independently diagnostic factors for PTB.

Conclusions

Morphological features derived from ¹⁸F-FDG PET images helped distinguish solitary and solid PTB from NSCLC.

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Titel: PET morphology helps distinguish solitary and solid pulmonary tuberculosis from non-small cell lung cancer
verfasst von: Qiang Li
Yuan Li
Hui Yuan
Fujun Yang
Yan Huang
Xiao Song
Lei Jiang
Publikationsdatum: 13.10.2022
Verlag: Springer Nature Singapore
Erschienen in: Japanese Journal of Radiology / Ausgabe 3/2023
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-022-01351-5

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PET morphology helps distinguish solitary and solid pulmonary tuberculosis from non-small cell lung cancer