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The Additional Value of Attenuation Correction CT Acquired During 18F-FDG PET/CT in Differentiating Mature From Immature Teratomas

 Arthur Cho  ;  Se-woong Kim  ;  Jiyoun Choi  ;  Wonjun Kang  ;  Jong-doo Lee  ;  Mijin Yun 
 CLINICAL NUCLEAR MEDICINE, Vol.39(3) : 193-196, 2014 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Demography ; Diagnosis, Differential ; Fluorodeoxyglucose F18* ; Humans ; Infant ; Middle Aged ; Multimodal Imaging* ; Positron-Emission Tomography* ; Teratoma/diagnostic imaging* ; Tomography, X-Ray Computed* ; Young Adult
teratoma ; 18 F-FDG ; PET/CT ; attenuation correction CT
INTRODUCTION: Increased F-FDG uptake is often seen in soft-tissue components or in neuronal components of teratomas, which makes differentiation of mature and immature teratoma difficult using only F-FDG uptake. The distribution pattern of fat and calcification in teratomas is characteristic on CT, which can also be well seen on attenuation correction CT (AC-CT). We hypothesize that the fat and calcification distribution patterns on AC-CT taken during PET/CT will provide additional diagnostic information in differentiating between mature and immature teratomas. PATIENTS AND METHODS: This retrospective study included 34 patients (44 masses; mean age 32 ± 16.3 years, range 0.2-70 years) who underwent F-FDG PET/CT before surgical resection for teratomas. F-FDG equal to or higher than the liver was visually considered positive. AC-CT images acquired during PET/CT were reviewed for calcification and fat distribution patterns. AC-CT findings for immature teratomas were scattered fat and/or disperse coarse calcification. Pathologic results were categorized into mature and immature teratomas. SUVmax and AC-CT findings were correlated with pathologic results. RESULTS: Out of the 44 lesions, 11 teratomas were immature, with higher F-FDG uptake in these tumors (7.8 ± 4.10 vs. 2.1 ± 2.28, P < 0.001). SUVmax higher than 2.8 were 91% accurate, but fat and/or calcification patterns on AC-CT were extremely helpful in reducing false-positive findings based on F-FDG uptake alone. CONCLUSION: Characteristic fat and calcification patterns on AC-CT of PET/CT were extremely helpful in differentiating mature from immature teratomas, especially in mature teratomas with increased F-FDG uptake. This can potentially reduce unnecessary radiation exposure from additional contrast-enhanced CT.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jong Doo(이종두)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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