ORIGINAL RESEARCH article
Front. Med.
Sec. Nuclear Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1647670
Utility of 18F-FDG PET/CT for Diagnosing and Staging solitary malignant tumors of the spleen
Provisionally accepted
- 1Other, NAN CHANG, China
- 2Nanchang Medical College, Nanchang, China
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Objective: To evaluate the diagnostic and staging value of ¹⁸F-FDG PET/CT in solitary malignant tumors of the spleen (SMTS). Methods: We retrospectively analyzed clinical data, ¹⁸F-FDG PET/CT and contrast-enhanced CT findings from 25 pathologically confirmed SMTS cases. The PET/CT characteristics including lesion distribution, accompanying signs, maximum standardized uptake value (SUVmax), and pathological types were analyzed, with comparison of diagnostic and staging efficacy between PET/CT and contrast-enhanced CT. Results: All 25 SMTS cases showed FDG uptake on PET/CT: mild uptake in 2 cases (SUVmax 2.4 and 2.3 respectively), moderate uptake in 8 cases (SUVmax 6.4±3.5), and intense uptake in 15 cases (SUVmax 15.8±4.2). The metabolic patterns included homogeneous uptake (13 cases), rim-like uptake (10 cases), and diffuse uptake (2 cases). CT morphology revealed round/oval lesions in 16 cases (64%, longest diameter 11.8±4.5 cm), irregular lesions in 7 cases (28%, 17.6±5.7 cm), and diffuse splenomegaly in 2 cases (8%, 18.4±2.7 cm). Lesions demonstrated well-defined margins (4 cases) or ill-defined margins (21 cases), with central necrosis/cystic degeneration/hemorrhage (13 cases) or solid appearance (12 cases). Contrast-enhanced CT showed mild (7 cases, 28%), moderate (8 cases, 32%), and marked enhancement (9 cases, 36%). Pathological types included lymphoma (14 cases, mostly showing homogeneous hypermetabolism except 2 MALT lymphomas with hypometabolism), angiosarcoma (7 cases, all demonstrating rim-like uptake with with photopenia in the necrotic centers), other sarcomas (3 cases including 2 EBV-positive inflammatory follicular dendritic cell sarcomas with well-defined hypermetabolic lesions and 1 unclassified sarcoma with heterogeneous uptake), and solitary metastasis (1 case showing nodular hypermetabolism). PET/CT demonstrated significantly higher diagnostic sensitivity (84% vs 68%, p=0.012) and superior staging capability (28% vs 12%, p=0.027) compared to CT,The diagnostic sensitivity of PET/CT combined with enhanced CT was 96%. Conclusion: ¹⁸F-FDG PET/CT provides significant diagnostic and staging value for SMTS, with SUVmax and metabolic patterns improving diagnostic accuracy. The combination of PET/CT and pathological biopsy is recommended for optimal evaluation.
Keywords: solitary malignant tumors of the spleen, Spleen, diagnose, CT, 18F-FDG PET/CT
Received: 16 Jun 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Shao, Xu, Fan and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wanling Qi, 670028208@qq.com
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