Value of 18F-FDG PET/computed tomography in predicting the simplified WHO grade of malignancy in thymic epithelial tumors

Objective To investigate the value of 18F-fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (CT) in predicting the simplified WHO grade of malignancy in thymic epithelial tumors. Materials and methods We retrospectively reviewed 81 patients with pathologically proven thymic epithelial tumors who underwent 18 F-FDG PET/CT before surgical resection. Maximum standardized uptake value (SUVmax) and SUVmax/tumor size were measured on the primary lesion. A receiver operating characteristics (ROC) curve were performed for assessing the ability of 18 F-FDG PET/CT as a predictor of the simplified WHO classification. Results There were 43 male patients (53.1%) and 38 female patients (46.9%), and the mean age was 55.6 ± 11.9 years. The mean tumor size was 53.2 ± 21.4 mm. There were 24 low-risk thymomas (29.6%) (A, AB, and B1), 29 high-risk thymomas (35.8%) (B2 and B3), and 28 thymic carcinomas (34.6%). The SUVmax and SUVmax/tumor size were found to be predictive factors that were useful to distinguish thymomas and thymic carcinomas, and area under the ROC curve were 0.820 and 0.691, respectively ( P < 0.05), and the cutoff value for discriminating thymomas and thymic carcinomas was 5.34. Conclusion In conclusion, a significant relationship was observed between SUVmax, SUVmax/tumor size and histological WHO classification of thymic epithelial tumors. 18 F-FDG PET/CT may be useful for predicting the grade of malignancy in thymic epithelial.