Biological characteristics of ¹⁸F-FDG PET/CT imaging of cerebral alveolar echinococcosis

Abstract

This study aims to analyze the characteristics of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸F-FDG PET/CT) for cerebral alveolar echinococcosis (CAE).

Twenty-five CAE patients underwent ¹⁸F-FDG PET/CT, and the diagnosis was confirmed by clinical and surgical pathology. The ¹⁸F-FDG PET/CT results were subject to visual and semiquantitative analysis, and the difference in ¹⁸F-FDG SUV _max for lesions among the 3 types of CAE was evaluated.

In the 25 CAE patients, 62 lesions were detected by ¹⁸F-FDG PET/CT, and these lesions were classified into 3 types, according to the characteristics of the lesion's uptake of ¹⁸F-FDG on PET images: type I, 17 lesions, FDG was concentrated into a mass radioactive distribution in the CAE foci; type II, 28 lesions, FDG presented a annular concentrated radioactive distribution around the CAE foci; type III, 17 lesions, FDG in the CAE foci presented a radioactive distribution with defects and sparse areas. The difference in ¹⁸F-FDG SUV _max between type I and type II CAE was not statistically significant ( P > .05), the difference in ¹⁸F-FDG SUV _max between type I and type III CAE was statistically significant ( P < .001), and the difference in ¹⁸F-FDG SUV _max between type II and type III CAE was statistically significant ( P < .001);

The ¹⁸F-FDG PET manifestations of CAE are classified into 3 types. Both type I and type II may have invasive activity, while the lesions of type III CAE show that the focus is relatively stable or at a stationary phase. If there are no definite alveolar echinococcus focus in other sites, these patients can temporarily delay the treatment. It is recommended that the patient should undergo whole body PET/CT once a year to dynamically observe the bioactivity and size of type III CAE lesions and assess the presence of new echinococcus lesions in the rest of the body.