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Inflammatory myofibroblastic tumor: FDG PET/CT findings with pathologic correlation
Aisheng Dong1, Yang Wang, Hui Dong
1From the *Departments of Nuclear Medicine and †Pathology, Changhai Hospital, Second Military Medical University, Shanghai; ‡Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai; and §Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Fluorodeoxyglucose F-18 (F-FDG) PET/CT imaging shows variable uptake in inflammatory myofibroblastic tumors (IMTs). This imaging technique can help detect primary IMTs, recurrences, and metastases.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with unpredictable behavior.
- Accurate diagnosis and staging of IMT are crucial for appropriate management.
- Fluorodeoxyglucose F-18 (F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) is a valuable imaging modality in oncology.
Purpose of the Study:
- To retrospectively evaluate F-FDG PET/CT findings in patients with IMT.
- To correlate F-FDG PET/CT findings with histopathological features of IMT.
- To assess the utility of F-FDG PET/CT in detecting IMT and its potential for recurrence or metastasis.
Main Methods:
- Retrospective review of F-FDG PET/CT scans in 6 patients with IMT (including one with transformation to spindle cell sarcoma).
- Analysis of tumor location, size, maximal standardized uptake value (SUVmax), and correlation with pathology.
- Pre-surgical PET/CT scans were performed, with a follow-up scan in one patient.
Main Results:
- Ten lesions were identified across various locations including liver, retroperitoneum, spleen, lung, and bone.
- Pathological confirmation of seven IMTs and one spindle cell sarcoma.
- Mean SUVmax was 10.9 ± 5.5 (range 3.3–20.8), with higher uptake correlating with increased cellularity, nuclear atypia, and proliferative index.
- One patient showed local recurrence and distant metastases on follow-up PET/CT.
Conclusions:
- F-FDG uptake in IMTs is variable and influenced by cellularity, tumor cell biology, inflammatory cell composition, and activation status.
- F-FDG PET/CT is a useful tool for detecting primary IMTs, identifying local recurrences, and staging distant metastases.
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