ArticleFrontiers in medicine2025
Utility of 18F-FDG PET/CT for diagnosing and staging solitary malignant tumors of the spleen.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the diagnostic and staging value of 18F-FDG PET/CT in solitary malignant tumors of the spleen (SMTS). Methods: We retrospectively analyzed clinical data, 18F-FDG PET/CT and contrast-enhanced CT findings from 25 pathologically confirmed SMTS cases. The PET/CT characteristics including lesion distribution, accompanying signs, maximum standardized uptake value (SUVmax), and pathological types were analyzed, with comparison of diagnostic and staging efficacy between PET/CT and contrast-enhanced CT. Results: All 25 SMTS cases showed FDG uptake on PET/CT: mild uptake in 2 cases (SUVmax 2.4 and 2.3 respectively), moderate uptake in 8 cases (SUVmax 6.4 ± 3.5), and intense uptake in 15 cases (SUVmax 15.8 ± 4.2). The metabolic patterns included homogeneous uptake (13 cases), rim-like uptake (10 cases), and diffuse uptake (2 cases). CT morphology revealed round/oval lesions in 16 cases (64%, longest diameter 11.8 ± 4.5 cm), irregular lesions in 7 cases (28%, 17.6 ± 5.7 cm), and diffuse splenomegaly in 2 cases (8%, 18.4 ± 2.7 cm). Lesions demonstrated well-defined margins (4 cases) or ill-defined margins (21 cases), with central necrosis/cystic degeneration/hemorrhage (13 cases) or solid appearance (12 cases). Contrast-enhanced CT showed mild (7 cases, 28%), moderate (8 cases, 32%), and marked enhancement (9 cases, 36%). Pathological types included lymphoma (14 cases, mostly showing homogeneous hypermetabolism except 2 MALT lymphomas with hypometabolism), angiosarcoma (7 cases, all demonstrating rim-like uptake with with photopenia in the necrotic centers), other sarcomas (3 cases including 2 EBV-positive inflammatory follicular dendritic cell sarcomas with well-defined hypermetabolic lesions and 1 unclassified sarcoma with heterogeneous uptake), and solitary metastasis (1 case showing nodular hypermetabolism). PET/CT demonstrated significantly higher diagnostic sensitivity (84% vs. 68%, Conclusion: 18F-FDG PET/CT provides significant diagnostic and staging value for SMTS, with SUVmax and metabolic patterns improving diagnostic accuracy. The combination of PET/CT and pathological biopsy is recommended for optimal evaluation.
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