在 18F-氟脱氧葡萄糖 (FDG) PET/CT 上，活动性结节病灶通常很难与恶性病变区分开来。我们研究了葡萄糖代谢率（MRglc，mg/min/100 mL）的潜力，这是一种基于线性 Patlak 分析直接重建的葡萄糖代谢动力学的新量化方法，用于区分结节病和恶性病变。总共 100 名患者纳入了心脏结节病 (CS) 患者和 67 名接受四维 FDG PET/CT 的癌症患者。标准扫描中标准化摄取值（SUV） ≥ 2.7的病灶作为活动病灶纳入分析。 SUV 和 MRglc 是使用四维 FDG PET/CT 上 30 分钟到 50 分钟之间采集的数据得出的。测量感兴趣体积（尺寸1.5cm3）的平均值。使用接受者操作特征（ROC）分析评估MRglc和SUV对结节病的诊断性能。 44名CS患者（18名男性，63.4±12.2岁）总共90个结节病病灶和57名癌症患者的87个恶性病灶对患者（32 名男性，65±14 岁）进行了分析。结节病灶的 SUV 和 MRglc 显着低于恶性病灶（SUV，4.98±2.00 vs 6.21±2.14；MRglc，2.52±1.39 vs 3.68±1.61；p<0.01）。 ROC 分析表明，区分结节病患者和恶性肿瘤患者的能力曲线下面积分别为 0.703 和 0.754，SUV 5.025 和 MRglc 2.855 的敏感性分别为 64% 和 77%，特异性为 75% 和 72%。 MRglc结节病灶中的结节病灶明显低于恶性病灶，与单独的 SUV 相比，提高了结节病灶的识别率。与单独的 SUV 相比，MRglc 提高了结节病淋巴结的识别率，并有望通过消除延迟扫描来缩短检查时间。活动性结节病灶有时与 FDG 积累相关应与恶性病变鉴别。 SUV与葡萄糖代谢率(MRglc)强正相关，MRglc可以区分结节病和恶性病变。 MRglc 可以对恶性病变进行准确的评估和分期。© 2024。作者，获得欧洲放射学会的独家许可。

On 18F-Fludeoxyglucose (FDG) PET/CT, active sarcoid lesions are often difficult to differentiate from malignant lesions. We investigated the potential of the glucose metabolic rate (MRglc, mg/min/100 mL), a new quantification of glucose metabolic kinetics derived from direct reconstruction based on linear Patlak analysis, to distinguish between sarcoidosis and malignant lesions.A total of 100 patients with cardiac sarcoidosis (CS) and 67 patients with cancer who underwent four-dimensional FDG PET/CT were enrolled. The lesions with a standardized uptake value (SUV) ≥ 2.7 on the standard scan were included as active lesions in the analysis. SUV and MRglc were derived using data acquired between 30 min and 50 min on four-dimensional FDG PET/CT. The mean value in the volume of interest (size 1.5 cm3) was measured. The diagnostic performance of sarcoidosis using MRglc and SUV was evaluated using receiver-operating-characteristic (ROC) analysis.A total of 90 sarcoidosis lesions from 44 CS patients (18 males, 63.4 ± 12.2 years) and 87 malignant lesions from 57 cancer-bearing patients (32 males, 65 ± 14 years) were analyzed. SUV and MRglc for sarcoid lesions were significantly lower than those for malignant lesions (SUV, 4.98 ± 2.00 vs 6.21 ± 2.14; MRglc, 2.52 ± 1.39 vs 3.68 ± 1.61; p < 0.01). ROC analysis indicated that the ability to discriminate sarcoid patients from those with malignancy yielded areas under the curves of 0.703 and 0.754, with sensitivities of 64% and 77% and specificities of 75% and 72% for SUV 5.025 and MRglc 2.855, respectively.MRglc was significantly lower in sarcoid lesions than malignant lesions, and improved sarcoid lesions identification over SUV alone.MRglc improves sarcoid lymph node identification over SUV alone and is expected to shorten the examination time by eliminating delayed scans.Active sarcoid lesions are sometimes associated with FDG accumulation and should be differentiated from malignant lesions. SUV and metabolic rate of glucose (MRglc) strongly positively correlated, and MRglc could differentiate sarcoid and malignant lesions. MRglc allows for accurate evaluation and staging of malignant lesions.© 2024. The Author(s), under exclusive licence to European Society of Radiology.