| Objective:Through the analysis of the basic clinical characteristics,imaging manifestations and the difference of 18F-FDG PET-CT SUVmax value between the different ranges and stages of sarcoidosis and the difference between pulmonary sarcoidosis and lymph node metastasis of lung cancer,the application value of 18F-FDG PET-CT in the clinical diagnosis of sarcoidosis was determined.Methods:We collected 21 sarcoidosis and 21 lung cancers with lymph node metastasis who were diagnosed by pathological or had definite diagnosis after 2 years of follow-up,all of them had the complete medical records and 18F-FDG PET-CT imaging data from the people’s Hospital of Zhengzhou University(Henan Provincial People’s Hospital),From May 2015 to December 2019.All patients were examined by 18F-FDG PET-CT,and the fusion images were analyzed by Medex workstation.Through retrospective analysis of the two groups of patients with general characteristics,clinical manifestations,imaging characteristics and SUVmax value of lesion site and other relevant information,and summarized and compared.Results:1.There were 21 patients with pulmonary sarcoidosis,8 males and 13 females,with an average age of 57.28±10.05 years.And 21 lung cancer patients,15 males and 6 females,with an average age of 60.23±9.60 years.There was statistical difference in gender(p<0.05)but no statistical difference in age between the two groups(P>0.05).2.Compared with lung cancer patients,pulmonary sarcoidosis patients are more prone to skin lesions(P<0.01),asthma(P<0.05),chest pain(P<0.05),while lung cancer patients with hemoptysis(P<0.05),emaciation(P<0.05)are more common than pulmonary sarcoidosis patients,and lung cancer patients have more smoking history.The imaging manifestations of sarcoidosis are bilateral symmetric hilar lymphadenopathy,while the lymph node metastasis of lung cancer is unilateral hilar lymphadenopathy.And many patients with sarcoidosis will have extrathoracic lymph node involvement.3.There was no significant relationship between SUVmax and sarcoidosis stage,nor the extent of disease(P>0.05).But there was a positive linear correlation between the SUVmax value and the size of lymph nodes(r=0.822;p<0.01).4.The mean value of SUVmax of the enlarged lymph nodes in the sarcoidosis group was 8.60,and that in the metastasis group was 5.27,there was significant difference between them(P＝0.005).When SUVmax=6.715,the area under ROC curve is 0.773,the sensitivity and specificity of diagnosing pulmonary sarcoidosis are 81%and 66.7%,respectively.Conclusion:The SUVmax value of 18F-FDG PET-CT has no significant statistical difference between the patients with different involvement range and different stages of pulmonary sarcoidosis,so it can not be used as the index of diagnosis stage.However,the SUVmax value of 18F-FDG PET-CT has significant statistical difference between the patients with pulmonary sarcoidosis and lymph node metastasis of lung cancer.However,the specificity of PET-CT SUVmax value in diagnosis of pulmonary sarcoidosis is not high,therefore,when 18F-FDG PET-CT appears hypermetabolic lesions of multiple organs in the whole body,the possibility of various results should be carefully considered. |
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