Zehra Pınar KOÇ, Rabia BOZDOĞAN ARPACI, Yüksel BALCI, Gülhan ÖREKİCİ, Pelin ÖZCAN KARA, Eylem SERCAN ÖZGÜR

Plevral plakların F-18 Fdg Pet/ct ve Ct ile değerlendirilmesi

Giriş: Plevral plakların malign olma olasılığı vardır ve bu antitenin araştırılması çok önemli olup en önemli radyolojik belirteç genel olarak florodeoksiglukoz (FDG) tutulumudur. Ancak bu konu ile ilgili daha önceki çalışmalar ve literatür bilgileri arasında uyumsuzluklar vardır. Bu çalışmanın amacı plevral plaklarda standardize tutulum değeri (SUD) ve malignite açısından kesim değerinin analizi ve bulguların bilgisayarlı tomografi (BT) ile karşılaştırılmasıdır. Materyal ve Metod: Yetmiş bir hasta (27 K, 44 E; ortalama yaş: 59.9 ± 13.1) çalışmaya dahil edilmiştir. Onkolojik amaçlı F-18 FDG PET/BT tüm hastalara uygulanmıştır. Pozitron emisyon tomografi/bilgisayarlı tomografi (PET/BT) görüntülerinin BT kısmından elde edilen görüntülerde tanımlanan plevral plaklar bağımsız bir Radyoloji Uzmanı tarafından kontrastlı veya kontrastsız BT görüntüleri üzerinden değerlendirilmiş ve sonuçlar altın standard patoloji olmak üzere karşılaştırılmıştır. Bulgular: Tanısal sensitivite, spesifisite BT için %39, %79 sırasıyla ve SUVmax için kesim değeri 4.8 kabul edildiğinde PET için %71 ve %63 sırasıyla bulunmuştur. Sonuç: Bizim çalışmamızın sonuçlarına göre ROC eğrileri ile belirlenen plevral plaklar için malignite için en uygun kesim değeri 4.8 olarak hesaplanmıştır. Bu kesim değeri kabul edildiğinde PET/BT’nin sensitivite ve doğruluğu BT’ye göre yüksek bulunmuştur.

The F-18 Fdg Pet/ct and Ct evaluation of pleural plaques

Introduction: Pleural plaques have the possibility of bearing malignancy thusinvestigation of this entity is important and the most important indicator ofmalignancy in general is fluorodeoxyglucose (FDG) accumulation in radiological appearance. However there is discrepancy between results of previousstudies in the literature about this subject. The aim of this study is to analyzethe standardized uptake value of pleural plaques and the cut off levels formalignancy in comparison with computed tomography (CT).Materials and Methods: Seventy one patients were included in the study (27F,44M; mean: 59.9 ± 13.1 years). Oncologic F-18 FDG positron emissiontomography/computed tomography (PET/CT) was performed to all the subjects for a different primary tumor. Pleural plaques were identified in allpatients in CT component of PET/CT examination. Contrast enhanced andnonenhanced CT images were evaluated by a Radiology Physician independently according to the gold standard pathology.Results: The diagnostic sensitivity, specificity of CT was; 39%, 79% respectively and if the cut-off SUVmax level was accepted "4.8" the diagnostic sensitivity and specificity of PET was 71%, and 63% respectively.Conclusion: According to the results and ROC curves determined in the study the cut-off level for evaluation of pleural plaques inPET examination was "4.8". The sensitivity and accuracy of PET was higher compared to CT with this cut-off value.

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