Could SUVmax be an auxiliary parameter in the clinical management of pulmonary hydatid disease?

Abstract

Objective The aim of this study was to investigate the role of 18F‐fluorodeoxyglucose positron emission tomography/computerized tomography (FDG‐PET/CT) in the diagnosis and treatment of pulmonary hydatid disease and also compare the morphological characteristics of the lesions with SUVmax values and identify complicated disease. Methods Thirty‐six patients with a diagnosis of pulmonary hydatid disease who underwent 18F‐FDG PET/CT imaging were included in this retrospective study. The size of the lesions, morphological characteristics, accompanying parenchymal and pleural findings, SUVmax and HUmean values and FDG uptake in mediastinal lymph nodes were noted. The relationship between morphologic properties, SUVmax of the lesions and lymphatic FDG uptake was analysed. Results A total of 99 lesions of 36 patients were classified as solid (7.1%), cystic (53.5%), semisolid (20.2%) and cavitary (19.2%). Thirty‐two of the lesions were encapsulated, 38 of the lesions had border irregularity. Accompanying consolidation was present in 10 cases, bronchial obstruction in 9, pleural thickening in 28 and effusion in 3. There was positive correlation between lesions HUmean and SUVmax values (r = 0.285). SUVmax values were significantly higher in lesions with irregular borders, solid or semisolid type and presence of consolidation, bronchial obstruction and pleural thickening. Also more lymphatic FDG uptake was detected in this group. Conclusion Higher SUVmax values may be a useful parameter in the diagnosis of complicated pulmonary hydatid disease. FDG‐PET may provide guidance for determining the priority of lesion for surgery in cases with multiple lesions and may be helpful to evaluate the response to medical treatment.

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

“…Several studies published in the last decade have explored the usefulness of advanced imaging techniques, including ultrasound elastography, CT, and DW-MRI, for the differential diagnosis of cystic echinococcosis and other lesions; however, results were variable and overall disappointing when coming to clinical usefulness [16][17][18][19][20][21][22][23]. FDG-PET/CT, which has a defined role in alveolar echinococcosis, has been also applied to cystic echinococcosis, with potential usefulness to evaluate the presence of inflammatory complications [24][25][26], but not for evaluation of CE cysts in terms of viability [27].…”