使用 CT 预测纯毛玻璃结节 (GGN) 的恶性程度具有挑战性。 [18F]FDG PET/CT 在这种情况下的最佳作用尚未明确。我们比较了 [18F]FDG PET/CT 与 CT 评估 GGN 预测浸润性腺癌 (IAC) 的性能。从 2012 年 6 月至 2020 年 12 月，我们回顾性纳入了 CT 上纯 GGN 且接受 [18F]FDG PET/CT 的患者90 天内。总体而言，38 例 40 ≥ 1 cm GGN 患者均得到病理证实。分析 CT 图像的大小、衰减、均匀性、形状、边缘、肿瘤-肺界面以及内部/周围特征。在 PET/CT 上评估目视 [18F]FDG 阳性、最大标准化摄取值 (SUVmax) 和组织分数校正 SUVmax (SUVmaxTF)。 40 个 GGN 的组织病理学为：25 个 IAC（62.5%）、9 个微创腺癌（MIA，22.5%）和 6 个原位腺癌（AIS，15.0%）。组织病理学CT表现无显着差异，而目视[18F]FDG阳性、SUVmax和SUVmaxTF有显着差异（P分别为0.001、0.033和0.018）。大小、视觉[18F]FDG阳性、SUVmax和SUVmaxTF显示出预测IAC的显着诊断性能（曲线下面积分别=0.693、0.773、0.717和0.723；P分别=0.029、0.001、0.018和0.013 ）。在多变量逻辑回归分析中，视觉 [18F]FDG 阳性在各种 CT 和 PET 结果中区分 GGN 中的 IAC（P=0.008）。[18F]FDG PET/CT 在区分 IAC 与 AIS/MIA 方面表现出优于 CT 的诊断性能在纯 GGN 中，它有潜力指导纯 GGN 患者的正确管理。© 2024。作者，经日本核医学会独家许可。

Predicting the malignancy of pure ground-glass nodules (GGNs) using CT is challenging. The optimal role of [18F]FDG PET/CT in this context has not been clarified. We compared the performance of [18F]FDG PET/CT in evaluating GGNs for predicting invasive adenocarcinomas (IACs) with CT.From June 2012 to December 2020, we retrospectively enrolled patients with pure GGNs on CT who underwent [18F]FDG PET/CT within 90 days. Overall, 38 patients with 40 ≥ 1-cm GGNs were pathologically confirmed. CT images were analyzed for size, attenuation, uniformity, shape, margin, tumor-lung interface, and internal/surrounding characteristics. Visual [18F]FDG positivity, maximum standardized uptake value (SUVmax), and tissue fraction-corrected SUVmax (SUVmaxTF) were evaluated on PET/CT.The histopathology of the 40 GGNs were: 25 IACs (62.5%), 9 minimally invasive adenocarcinomas (MIA, 22.5%), and 6 adenocarcinomas in situ (AIS, 15.0%). No significant differences were found in CT findings according to histopathology, whereas visual [18F]FDG positivity, SUVmax, and SUVmaxTF were significantly different (P=0.001, 0.033, and 0.018, respectively). The size, visual [18F]FDG positivity, SUVmax, and SUVmaxTF showed significant diagnostic performance to predict IACs (area under the curve=0.693, 0.773, 0.717, and 0.723, respectively; P=0.029, 0.001, 0.018, and 0.013, respectively). In the multivariate logistic regression analysis, visual [18F]FDG positivity discriminated IACs among GGNs among various CT and PET findings (P=0.008).[18F]FDG PET/CT demonstrated superior diagnostic performance compared to CT in differentiating IAC from AIS/MIA among pure GGNs, thus it has the potential to guide the proper management of patients with pure GGNs.© 2024. The Author(s), under exclusive licence to The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.