Application Value of PET/CT and MRI in the Diagnosis and Treatment of Patients With Synchronous Multiple Pulmonary Ground-Glass Nodules

Abstract

BackgroundSynchronous multiple ground-glass nodules (SMGGNs) in synchronous multiple lung cancers are associated with specific imaging findings. It is difficult to distinguish whether multiple nodules are primary tumors or metastatic lesions in the lungs. The need for PET/CT and contrast-enhanced brain MRI for these patients remains unclear. This study investigated the necessity of these two imaging examinations for SMGGN patients by means of retrospective analysis.MethodsSMGGN patients who were diagnosed and treated in our hospital from October 2017 to May 2020 and underwent whole-body PET/CT(Cranial excepted) and/or contrast-enhanced brain MRI+DWI were enrolled in this study. We analyzed the imaging and clinical characteristics of these patients to evaluate SMGGN patients’ need to undergo whole-body PET/CT and brain MRI examination.ResultsA total of 87 SMGGN patients were enrolled. 51 patients underwent whole-body PET/CT examinations and did not show signs of primary tumors in other organs, metastatic foci in other organs, or metastasis to surrounding lymph nodes. 87 patients underwent whole-brain MRI, which did not reveal brain metastases but did detect an old cerebral infarction in 23 patients and a new cerebral infarction in one patient. 87 patients underwent surgical treatment in which 219 nodules were removed. All nodules were diagnosed as adenocarcinoma or atypical adenomatous hyperplasia. No lymph node metastasis was noted.ConclusionFor SMGGN patients, PET/CT and enhanced cranial MRI are unnecessary for SMGGNs patients, but from the perspective of perioperative patient safety, preoperative MRI+DWI examination is recommended for SMGGNs patients.

Potential Role of Intrapulmonary Concomitant Lesions in Differentiating Non-Neoplastic and Neoplastic Ground Glass Nodules

“…In contrast, GGNs in the contralateral lung were more commonly detected in patients with neoplastic GGNs. It indicates that scattered GGNs in bilateral lungs had a higher possibility of neoplasm, 26 , 27 and at the level of genetic research, multiple GGNs are often multifocal and independent cancers. 28 …”

“…In contrast, GGNs in the contralateral lung were more commonly detected in patients with neoplastic GGNs. It indicates that scattered GGNs in bilateral lungs had a higher possibility of neoplasm, 26,27 and at the level of genetic research, multiple GGNs are often multifocal and independent cancers. 28 Regarding the efficacy of different indicators or parameters in the differential diagnosis of non-neoplastic GGNs, the AUC of model based solely on CT features of target GGNs is higher than that only based on intrapulmonary concomitant lesions, but lower than that based on the combination of CT features of target GGNs and intrapulmonary concomitant lesions.…”