방사선의학 웹진

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Abstract

PURPOSE:

We investigated the capacity of F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) to differentially diagnose immunoglobulin G4-related disease (IgG4-RD) in clinically suspected patients.

MATERIALS AND METHODS:

Subjects were 94 clinically suspected patients who had tissue IgG4 staining (n = 85) or serum IgG4 greater than 135 mg/dL (n = 9) and underwent FDG PET/CT within 40 days. Clinical, serologic, pathological, and PET/CT findings were analyzed. Binary logistic regression analysis was performed to assess the diagnostic performance of PET/CT.

RESULTS:

Final diagnosis was IgG4-RD in 28, malignancy in 29, IgG4-unrelated inflammation in 35, and undetermined cause in 2 subjects. Patients with IgG4-RD had lower maximum standardized uptake value (SUVmax) of FDG uptake in lesions (4.6 ± 1.7 vs 7.1 ± 5.0) and higher submandibular gland SUVmax (2.8 ± 1.0 vs 2.3 ± 0.6) and were more likely to have diffuse/heterogeneous uptake pattern (78.6% vs 54.8%). The relation between SUVmax of lesions and histopathological findings was weak. On binary logistic regression analysis, lesion SUVmax, submandibular gland SUVmax, and multiorgan involvement were significant predictors of IgG4-RD and provided an area under the receiver operating characteristics curve of 0.824. With optimum criteria, FDG PET/CT had a sensitivity of 85.7% and specificity of 66.1% for diagnosing IgG4-RD.

CONCLUSIONS:

FDG PET/CT findings may have the capacity to potentially differentiate IgG4 RD from other diseases in clinically suspected patients. 

Author information​

Lee J1, Hyun SH, Kim S, Kim DK, Lee JK, Moon SH, Cho YS, Choe YS, Kim BT, Lee KH.

1From the Departments of *Nuclear Medicine, †Pathology, and ‡Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.