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FDG-PET/CT assessment of misty mesentery: feasibility for distinguishing viable mesenteric malignancy from stable conditions.

Abstract：

PURPOSE:"Misty mesentery" is a CT appearance of mesenteric fat changes with increased attenuation often existing with swelled mesenteric lymph nodes. We evaluated diagnostic performance of FDG-PET/CT in distinguishing viable malignant disorders from benign conditions in misty mesentery. MATERIALS AND METHODS:4236 FDG-PET/CT images were reviewed to identify patients with appearances of misty mesentery. Only the initial examinations were evaluated. Patients undergoing chemotherapy and/or radiotherapy within 3 months, patients with bulky mesenteric mass, and patients without follow-up examinations were excluded. Maximum short-axis diameter of mesenteric nodules (Diam-max) and maximum standardized uptake value (SUVmax) for mesenteric abnormalities were measured, and the diagnostic performance to differentiate between viable malignancy and stable lesions was assessed by receiver-operating characteristic (ROC) analysis, based on final diagnoses obtained by histology or follow-up examinations. Their significance was assessed by multivariate logistic regression. RESULTS:71 studies met the inclusion criteria with confirmed diagnoses (13 viable malignancies; 58 stable lesions). Of the 13 malignant cases, 12 were lymphoma. ROC curves indicated an optimal Diam-max cut-off value of >10mm and SUVmax cut-off of ≥3.0, with area under the curve of 0.961 and 0.926, respectively. Using the optimal Diam-max cut-off, sensitivity and specificity were 69% and 98%, respectively. Using the optimal SUVmax cut-off, they were 85% and 98%, respectively. The combination of either Diam-max>10mm or SUVmax≥3.0 had a sensitivity of 92%. Both Diam-max and SUVmax were significant independent factors for predicting malignancy. CONCLUSIONS:FDG-PET/CT is feasible for identifying viable malignancy in misty mesentery.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Nakatani K,Nakamoto Y,Togashi K

doi

10.1016/j.ejrad.2013.03.016

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

e380-5

issue

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(13)00162-9

journal_volume

pub_type

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FDG-PET/CT assessment of misty mesentery: feasibility for distinguishing viable mesenteric malignancy from stable conditions.