Can the Ratio SUVmax of the Lesion/SUVmax of Mediastinal Tissues Guide the Choice of Surgical Access for the Resection of Thymic Epithelial Tumors?

Frontiers in Surgery

article

Sotirios D. Moraitis¹  Apostolos C. Agrafiotis³  Evangelia Skoura⁴  Dimitrios Kalkanis⁴  Dimitrios Moraitis⁵  Periklis Tomos⁶  Theodoros Liakakos⁷  Dimitrios Angouras⁸ 

[1] Department of Joint Corps Armed Forces Cardiac Surgery, 401 Hellenic Army Hospital;Department of Thoracic Surgery, Athens Naval and Veterans Hospital;Department of Thoracic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles;Department of Nuclear Medicine;Department of Administration, Athens Naval and Veterans Hospital;Department of Thoracic Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens;Department of Surgery, Laikon University Hospital, Medical School, National and Kapodistrian University of Athens;Department of Cardiac Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens

关键词: standard uptake value;    surgical access;    thymic epithelial tumors;    thymoma;    thymic carcinoma;   

DOI  :  10.3389/fsurg.2022.852906

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background There are studies showing the utility of the 18-fluorodeoxyglucose positron emission tomography ( 18 FDG PET) scan in the management of patients with thymic epithelial tumors. It seems to be a correlation between the standard uptake value (SUVmax) of thymic epithelial tumors and the histological type and the stage. This study aims to use the ratio of the SUVmax of the lesion to the SUVmax of the adjacent mediastinal tissues in order to guide the choice of the surgical access. Methods All patients who presented an anterior mediastinal lesion with a high suspicion of being of thymic origin were included in a prospective database. A ratio inferior to 1 could predict a benign nature and less aggressive behavior, and a minimally invasive approach was performed. A ratio superior to 1 suggested a malignant and aggressive behavior, and a median sternotomy (or a thoracotomy) was performed. Results There were 15 male (mean age 44.6 ± 16.26 years, range 25–73) and 15 female patients (mean age 50.1 ± 16.94 years, range 25–76). When the ratio is inferior to 1, it predicts benign disease in 80% of cases. When it is superior to 1, it predicts in half of cases advanced histological types (high risk thymomas and thymic carcinomas). On the contrary, it can quite accurately predict advanced Masaoka–Koga stages. Conclusions The protocol of this study is in accordance with the current literature showing the utility of 18 FDG PET scan in the treatment of thymic epithelial tumors. This study goes one step further since the choice of surgical access is based on the SUVmax values. The ratio SUVmax of the lesion/SUVmax of the mediastinal tissues could be a new marker, more pertinent than absolute SUVmax values.

【 授权许可】

CC BY