Apport des paramètres métaboliques de la TEP/TDM au 18FDG dans la caractérisation ganglionnaire des cancers bronchopulmonaires non à petites cellules
DOI :
https://doi.org/10.62438/tunismed.v104i06.6470Mots-clés :
Tomographie par émission de positons, 18F-Fluorodésoxyglucose, Cancer bronchopulmonaire non à petites cellules, Ganglions lymphatiques, imagerie diagnostiqueRésumé
Introduction: Bien que l’histologie en soit le Gold Standard, plusieurs études s’intéressent à l’utilité de la Tomographie par Emission de Positons au 18F-Fluorodésoxyglucose couplée à la tomodensitométrie (TEP/TDM au 18FDG) dans la caractérisation ganglionnaire des cancers
bronchopulmonaires non à petites cellules (CBNPC).
Objectif: étudier la capacité discriminatoire des paramètres métaboliques de la TEP/TDM au 18FDG dans la caractérisation ganglionnaire.
Méthodes: Nous avons réalisé une étude rétrospective observationnelle incluant des patients adressés à notre service pour bilan d’extension de CBNPC par TEP/TDM au 18FDG. Nous avons mesuré le SUVmax ganglionnaire (SUVmaxG) et calculé les ratios de SUVmax normalisés au foie (SUVG/F), au médiastin (SUVG/M) et à la tumeur primitive (SUVG/T). Nous avons ensuite comparé ces paramètres métaboliques à l’histologie ou au suivi.
Résultats: Notre étude a inclus 43 patients et un total de 173 ganglions. Le SUVmaxG et le SUVG/F étaient les plus discriminants. Leur sensibilité et spécificité était supérieure à 90% et 85%.
Un cut-off moyen du SUVmaxG et du SUVG/F a été calculé :
• SUVmaxG=3,35 : Sensibilité et spécificité à 91,4 et 85,9%.
• SUVG/F=1,28 : Sensibilité et spécificité à 90,1 et 87,2%.
• SUVG/M=1,85 : Sensibilité et spécificité à 85,2 et 87,2%.
Conclusion: La TEP/TDM au 18FDG apparaît comme un outil performant pour la caractérisation ganglionnaire, pouvant contribuer à optimiser la stratégie thérapeutique.
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