F-18 fluorodeoxyglucose positron emission tomography for differential diagnosis and prognosis prediction of vascular tumors

Figures

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  Figure 1.. AS with multi-organ involvement on FDG-PET. A 68-year-old male patient (patient #26) exhibited multiple hypermetabolic lesions in the liver, bilateral adrenal glands, stomach and multiple bones. Liver biopsy confirmed AS (yellow arrows). The highest maximum standardized uptake value was measured in the left adrenal gland as 11.6. (A) Maximum intensity projection anterior image. (B) PET/CT fusion coronal image. (C) PET/CT fusion transaxial image. (D) Pathology from liver biopsy demonstrating AS (magnification, ×400). The upper panel demonstrates hematoxylin and eosin staining, and the lower demonstrates cluster of differentiation 31 staining. AS, angiosarcoma; FDG-PET, F-18 fluorodeoxyglucose positron emission tomography.

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  Figure 2.. EHE with multiple lesions in the right lung on FDG-PET. A 35-year-old male patient (patient #13) exhibited multiple hypermetabolic nodules in the right lung. Percutaneous needle biopsy over the right lung lesion revealed the EHE lesion. The highest maximum standardized uptake value of the right middle lobe lesion was 6.7. (A) Maximum intensity projection anterior image. (B) PET/CT fusion axial images. (C) Pathology from the percutaneous needle biopsy revealing EHE (magnification, ×400). The upper panel demonstrates hematoxylin and eosin staining, and the lower demonstrates cluster of differentiation 31 staining. EHE, epithelioid hemangioendothelioma; FDG-PET, F-18 fluorodeoxyglucose positron emission tomography.

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  Figure 3.. HEM with a single lesion with mild FDG uptake on FDG-PET. A 46-year-old male patient (patient #1) exhibited a soft tissue mass in the left axilla that extended to the chest wall (red arrows). Maximum standardized uptake value of the mass lesion was 2.1. Wide excision confirmed the presence of HEM. (A) Maximum intensity projection anterior image. (B) PET/CT fusion coronal image. (C) PET/CT fusion transaxial image. (D) Pathology from left axilla demonstrating HEM (magnification, ×100). The upper panel demonstrates hematoxylin and eosin staining, and the lower demonstrates cluster of differentiation 31 staining. HEM, hemangioma; FDG-PET, F-18 fluorodeoxyglucose positron emission tomography.

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  Figure 4.. FDG uptake of the vascular tumors. AS exhibited a higher SUVmax (6.32±4.84) compared with EHE (3.10±2.68) and HEM (2.33±0.76; P=0.0284 by Kruskal-Wallis test). There was no difference between EHE and HEM (P>0.05). Horizontal bars indicate the mean value of SUVmax. AS, angiosarcoma; EHE, epithelioid hemangioendothelioma; HEM, hemangioma; FDG, fluorodeoxyglucose; SUVmax, maximum standardized uptake value.

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  Figure 5.. Survival curve analysis according to the cutoff SUVmax of 3.0. The 12 patients with higher SUVmax (7.45±4.36) exhibited significantly poorer disease progression-free survival compared with the 14 patients with lower SUVmax (1.97±0.61; P=0.0053 by log rank test). SUVmax, maximum standardized uptake value.