Differential diagnostic performance of PET/CT in adult-onset still's disease and lymphoma: a retrospective pilot study.

Content Provider	Europe PMC
Author	Wan, Liyan Gao, Yuting Yang, Chendie Gu, Jieyu Liu, Tingting Hu, Qiongyi Tang, Zihan Teng, Jialin Liu, Honglei Cheng, Xiaobing Ye, Junna Su, Yutong Shi, Yi Huang, Xinyun Yang, Chengde Li, Biao Shi, Hui Zhang, Min
Copyright Year	2023
Abstract	BackgroundAdult-onset still’s disease (AOSD) and lymphoma are the common causes of fever of unknown origin (FUO) and show some similar clinical symptoms. This study aimed to establish a reliable and easy-to-used scoring model based on clinical information, laboratory characteristics and 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) images for the differential diagnosis of these two diseases.MethodsA development cohort including 70 AOSD and 37 lymphoma patients was used to establish a scoring model based on the features of PET/CT images. The scoring model was then validated in a validation cohort of 15 AOSD and 12 lymphoma patients. The features of involved bone marrow, spleen, lymph nodes, and other organs or tissues displayed on PET/CT images were compared. Multiple logistics regression and decision tree analysis were used to establish the scoring model.ResultsFour features that could significantly differentiate these two diseases were selected to establish a scoring model discriminating AOSD from lymphoma, including (I) white blood cell (WBC) count ≤10×109/L (1 point); (II) ferritin ≤ upper limit of normal (ULN) (1 point); (III) no abnormal bone marrow metabolism (1 point); (IV) total lesion glycolysistotal (TLGtotal) >9.0 (1 point). After decision tree analysis, it showed that a score ≤1 indicates AOSD. A score ≥3 strongly suggested lymphoma, with a sensitivity of 81.1% and specificity of 90.0% in the development cohort, and a sensitivity of 58.3% and specificity of 100% in the validation cohort.ConclusionsOur scoring model showed good diagnosis performance in distinguishing AOSD from lymphoma.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9816740&blobtype=pdf
ISSN	22234292
Journal	Quantitative Imaging in Medicine and Surgery [Quant Imaging Med Surg]
Volume Number	13
DOI	10.21037/qims-22-246
PubMed Central reference number	PMC9816740
Issue Number	1
PubMed reference number	36620150
e-ISSN	22234306
Language	English
Publisher	AME Publishing Company
Publisher Date	2022-11-02
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Subject Keyword	18F-fluorodeoxyglucose positron emission tomography/computer tomography adult-onset still’s disease (AOSD) lymphoma differential diagnosis autoinflammatory disease
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging